MEDICARE: NADIA MAHARAJ RD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	913695	NY

General Provider Information

NPI Number	:	1174096143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NADIA MAHARAJ RD

Provider Business Mailing Address
First Line	:	1434 WILLIAMSBRIDGE RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-2507
Country	:	US
Telephone Number	:	718-583-7736
Fax Number	:	646-350-1634

Provider Business Practice Location Address
First Line	:	1434 WILLIAMSBRIDGE RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461
Country	:	US
Telephone Number	:	718-583-7736
Fax Number	:	646-350-1634

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2019
Last Update Date	:	10/28/2019

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