Provider Demographics
NPI:1275059966
Name:BERKOWITZ, SHOSHANA (RDN)
Entity Type:Individual
Prefix:MRS
First Name:SHOSHANA
Middle Name:
Last Name:BERKOWITZ
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:SHOSHANA
Other - Middle Name:
Other - Last Name:MARCUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13 5TH ST APT 6
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-3252
Mailing Address - Country:US
Mailing Address - Phone:917-561-0091
Mailing Address - Fax:
Practice Address - Street 1:13 5TH ST APT 6
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-3252
Practice Address - Country:US
Practice Address - Phone:917-561-0091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered