Provider Demographics
NPI:1033440508
Name:FREEDMAN, SHOSHANA (RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:SHOSHANA
Middle Name:
Last Name:FREEDMAN
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:MISS
Other - First Name:SHOSHANA
Other - Middle Name:
Other - Last Name:ZEHNWIRTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6318 WIRT AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-3125
Mailing Address - Country:US
Mailing Address - Phone:410-514-6232
Mailing Address - Fax:845-350-5381
Practice Address - Street 1:6318 WIRT AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-3125
Practice Address - Country:US
Practice Address - Phone:410-514-6232
Practice Address - Fax:845-350-5381
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-24
Last Update Date:2010-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX2959133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered