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General NPI Number Information
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NPI Number | 1740307537
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Entity Type | Individual
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Provider Name | HAZEL ALLISON THOMAS RD
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Gender | Female
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Dates
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Enumeration Date | 03/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5018 AVENUE D
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City | BROOKLYN
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State | NY
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Zip | 11203-5906
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Country | US
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Telephone | 718-451-2800
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Fax | 718-451-2804
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Provider Business Mailing Address
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Address Line | 11022 198TH ST
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City | SAINT ALBANS
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State | NY
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Zip | 11412-1722
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Country | US
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Telephone | 718-465-0021
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 716482
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License Number State | IL
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