Provider Demographics
NPI:1376224881
Name:BOZYMSKI, CAROL (MS, RDN, CDN, LDN)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:BOZYMSKI
Suffix:
Gender:F
Credentials:MS, RDN, CDN, LDN
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:
Other - Last Name:STREEP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10 LIBERTY ST APT 7A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10005-1532
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:910 COVE POINT PL
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32963-3996
Practice Address - Country:US
Practice Address - Phone:201-477-0481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered