Provider Demographics
NPI:1588829261
Name:TAUB-DIX, BONNIE (MA,RD,CDN)
Entity Type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:
Last Name:TAUB-DIX
Suffix:
Gender:F
Credentials:MA,RD,CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 HEWLETT NECK RD
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1402
Mailing Address - Country:US
Mailing Address - Phone:516-295-0377
Mailing Address - Fax:516-295-8692
Practice Address - Street 1:131 HEWLETT NECK RD
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1402
Practice Address - Country:US
Practice Address - Phone:516-295-0377
Practice Address - Fax:516-295-8692
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000370133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered