Provider Demographics
NPI:1114435120
Name:HOLTZER, ELISABETH (RD)
Entity Type:Individual
Prefix:MRS
First Name:ELISABETH
Middle Name:
Last Name:HOLTZER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MRS
Other - First Name:ELISABETH
Other - Middle Name:
Other - Last Name:HOLTZER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD
Mailing Address - Street 1:129 ADMIRALTY LOOP
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-3966
Mailing Address - Country:US
Mailing Address - Phone:917-613-7916
Mailing Address - Fax:
Practice Address - Street 1:719 N BEERS ST
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1522
Practice Address - Country:US
Practice Address - Phone:646-996-1009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-12
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered