Provider Demographics
NPI:1710666789
Name:SPIEGEL, LEAH (RDN)
Entity Type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:
Last Name:SPIEGEL
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 1:32 BRADHURST AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-6134
Mailing Address - Country:US
Mailing Address - Phone:718-337-8505
Mailing Address - Fax:
Practice Address - Street 1:32 BRADHURST AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-6134
Practice Address - Country:US
Practice Address - Phone:718-337-8505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered