Healthcare Provider Details

I. General information

NPI: 1730419359
Provider Name (Legal Business Name): SHARI HAMBURG MS, RD, CDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2010
Last Update Date: 01/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 MICHAEL RD
SYOSSET NY
11791-6421
US

IV. Provider business mailing address

12 MICHAEL RD
SYOSSET NY
11791-6421
US

V. Phone/Fax

Practice location:
  • Phone: 516-938-2233
  • Fax:
Mailing address:
  • Phone: 516-938-2233
  • 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: