Provider Demographics
NPI:1083381800
Name:MARAJ, JOY ALISA (RD)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:ALISA
Last Name:MARAJ
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:JOY
Other - Middle Name:ALISA
Other - Last Name:MARAJ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4380 VIREO AVE LBBY 10
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10470-2321
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4380 VIREO AVE LBBY 10
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10470-2321
Practice Address - Country:US
Practice Address - Phone:347-860-2662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-28
Last Update Date:2021-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY86013004133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered