Provider Demographics
NPI:1457503799
Name:SMOLARZ, SARI (MS, CNS, CDN)
Entity Type:Individual
Prefix:
First Name:SARI
Middle Name:
Last Name:SMOLARZ
Suffix:
Gender:F
Credentials:MS, CNS, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 ANDERSON RD
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-3714
Mailing Address - Country:US
Mailing Address - Phone:201-612-4347
Mailing Address - Fax:201-612-4325
Practice Address - Street 1:16 ANDERSON RD
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3714
Practice Address - Country:US
Practice Address - Phone:201-612-4347
Practice Address - Fax:201-612-4325
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-17
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY48-006526133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY48-006526Other48-006526
NY48-006526Other48-006526