Provider Demographics
NPI:1801413661
Name:CHAIMOVITZ, RAIZY (RDN, CDN)
Entity Type:Individual
Prefix:
First Name:RAIZY
Middle Name:
Last Name:CHAIMOVITZ
Suffix:
Gender:F
Credentials:RDN, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1451 E 27TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-5308
Mailing Address - Country:US
Mailing Address - Phone:347-631-2194
Mailing Address - Fax:
Practice Address - Street 1:1225 44TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-2080
Practice Address - Country:US
Practice Address - Phone:347-746-0453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-28
Last Update Date:2020-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009907133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered