Healthcare Provider Details

I. General information

NPI: 1316238801
Provider Name (Legal Business Name): ARIELLA HOROWITZ RD, CDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2011
Last Update Date: 05/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14412 69TH RD
FLUSHING NY
11367-1702
US

IV. Provider business mailing address

14412 69TH RD
FLUSHING NY
11367-1702
US

V. Phone/Fax

Practice location:
  • Phone: 718-614-2145
  • Fax: 718-658-6909
Mailing address:
  • Phone: 718-614-2145
  • Fax: 718-658-6909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number7077
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1013487
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: