Healthcare Provider Details

I. General information

NPI: 1639793672
Provider Name (Legal Business Name): BATSHEVA ZOLTY RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BATSHEVA HERZKA RDN

II. Dates (important events)

Enumeration Date: 06/05/2020
Last Update Date: 06/05/2020
Certification Date: 06/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 KEARSING PKWY
MONSEY NY
10952-2244
US

IV. Provider business mailing address

163 KEARSING PKWY
MONSEY NY
10952-2244
US

V. Phone/Fax

Practice location:
  • Phone: 347-860-2076
  • Fax:
Mailing address:
  • Phone: 347-860-2076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: