MEDICARE: AHUVA R SHEMESH MS 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	86370815

General Provider Information

NPI Number	:	1396535407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AHUVA R SHEMESH MS RD

Provider Business Mailing Address
First Line	:	1488 E 27TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-5309
Country	:	US
Telephone Number	:	347-768-3504
Fax Number	:

Provider Business Practice Location Address
First Line	:	1488 E 27TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-5309
Country	:	US
Telephone Number	:	718-375-0780
Fax Number	:

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

Provider Enumeration Date	:	05/12/2025
Last Update Date	:	05/12/2025

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