Provider Demographics
NPI:1811380793
Name:LESKOWITZ, JAMIE (MS RD CDN)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:LESKOWITZ
Suffix:
Gender:F
Credentials:MS RD CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 W 14TH ST
Mailing Address - Street 2:APT 6A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-5064
Mailing Address - Country:US
Mailing Address - Phone:973-945-7195
Mailing Address - Fax:
Practice Address - Street 1:136 MADISON AVE
Practice Address - Street 2:NEW YORK
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6711
Practice Address - Country:US
Practice Address - Phone:646-660-5661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered