Provider Demographics
NPI:1114097466
Name:ZWEIFACH, MARLEE (MS, RD, CDE,)
Entity Type:Individual
Prefix:MS
First Name:MARLEE
Middle Name:
Last Name:ZWEIFACH
Suffix:
Gender:F
Credentials:MS, RD, CDE,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 EASTERN DRIVE
Mailing Address - Street 2:
Mailing Address - City:ARDSLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10502-1927
Mailing Address - Country:US
Mailing Address - Phone:212-861-7268
Mailing Address - Fax:212-861-7429
Practice Address - Street 1:35 EAST 85TH STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0954
Practice Address - Country:US
Practice Address - Phone:212-861-7268
Practice Address - Fax:212-861-7429
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000529-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY9312E1Medicare ID - Type Unspecified