Provider Demographics
NPI:1285194936
Name:DEVJANI, KARISHMA (RD)
Entity Type:Individual
Prefix:
First Name:KARISHMA
Middle Name:
Last Name:DEVJANI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2775 SHORE PKWY APT 1D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-6508
Mailing Address - Country:US
Mailing Address - Phone:718-450-6558
Mailing Address - Fax:
Practice Address - Street 1:2775 SHORE PKWY APT 1D
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-6508
Practice Address - Country:US
Practice Address - Phone:718-450-6558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009537133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered