Provider Demographics
NPI:1407096738
Name:HAAS, MARIA (MS, RD,CDN)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:HAAS
Suffix:
Gender:F
Credentials:MS, RD,CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 ROUTES 5 AND 20
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:NY
Mailing Address - Zip Code:14081-9706
Mailing Address - Country:US
Mailing Address - Phone:716-951-7252
Mailing Address - Fax:716-951-7005
Practice Address - Street 1:845 ROUTES 5 AND 20
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:NY
Practice Address - Zip Code:14081-9706
Practice Address - Country:US
Practice Address - Phone:716-951-7252
Practice Address - Fax:716-951-7005
Is Sole Proprietor?:No
Enumeration Date:2009-02-26
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016458133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL016458OtherREGISTERED DIETITIAN