Provider Demographics
NPI:1114284981
Name:CHINITZ, JUDITH (MS)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:CHINITZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 ANNANDALE RD
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-1801
Mailing Address - Country:US
Mailing Address - Phone:914-244-1708
Mailing Address - Fax:
Practice Address - Street 1:39 ANNANDALE RD
Practice Address - Street 2:
Practice Address - City:CHAPPAQUA
Practice Address - State:NY
Practice Address - Zip Code:10514-1801
Practice Address - Country:US
Practice Address - Phone:914-244-1708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY08C542375133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist