Healthcare Provider Details

I. General information

NPI: 1669249819
Provider Name (Legal Business Name): HEALTHY HORIZONS DIETETICS-NUTRITION PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2023
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 TROSSACH RD
STATEN ISLAND NY
10304-2131
US

IV. Provider business mailing address

33 TROSSACH RD
STATEN ISLAND NY
10304-2131
US

V. Phone/Fax

Practice location:
  • Phone: 347-481-6434
  • Fax:
Mailing address:
  • Phone: 347-481-6434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ASMA ZAHID HUSAIN
Title or Position: REGISTERED DIETITIAN NUTRITIONIST
Credential: RDN, CDN
Phone: 347-481-6434