Provider Demographics
NPI:1558132779
Name:MOCZARSKI, ALEXANDRA K (RDN)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:K
Last Name:MOCZARSKI
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 E 83RD ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-4356
Mailing Address - Country:US
Mailing Address - Phone:201-788-9517
Mailing Address - Fax:
Practice Address - Street 1:327 E 83RD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-4356
Practice Address - Country:US
Practice Address - Phone:201-788-9517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86150506133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered