MEDICARE: NORMA SAFF 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

General Provider Information

NPI Number	:	1386954220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NORMA SAFF RD

Provider Business Mailing Address
First Line	:	1931 E 16TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-3401
Country	:	US
Telephone Number	:	718-376-3656
Fax Number	:	718-645-8507

Provider Business Practice Location Address
First Line	:	372 AVENUE U
Second Line	:	SUITE 1B
City	:	BROOKLYN
State	:	NY
Zip	:	11223-4018
Country	:	US
Telephone Number	:	718-645-8303
Fax Number	:

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

Provider Enumeration Date	:	10/13/2010
Last Update Date	:	10/13/2010

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