Provider Demographics
NPI:1346792199
Name:MENDEZ ESQUIVEL, STEFANIE M (RD)
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:M
Last Name:MENDEZ ESQUIVEL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:STEFANIE
Other - Middle Name:
Other - Last Name:TURNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:330 9TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-4026
Mailing Address - Country:US
Mailing Address - Phone:914-207-6703
Mailing Address - Fax:
Practice Address - Street 1:330 9TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-4026
Practice Address - Country:US
Practice Address - Phone:914-207-6703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-27
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008895133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered