Provider Demographics
NPI:1578268520
Name:HAMDAN, SARA (RDN)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:HAMDAN
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 1:33 HUDSON ST APT 2612E
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-7535
Mailing Address - Country:US
Mailing Address - Phone:917-828-3311
Mailing Address - Fax:
Practice Address - Street 1:33 HUDSON ST APT 2612E
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-7535
Practice Address - Country:US
Practice Address - Phone:917-828-3311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-31
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY86107992133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered