Provider Demographics
NPI:1821260316
Name:ZELL, ZEHAVA S (RD CDN)
Entity Type:Individual
Prefix:MRS
First Name:ZEHAVA
Middle Name:S
Last Name:ZELL
Suffix:
Gender:F
Credentials:RD CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1447 E 17TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-6703
Mailing Address - Country:US
Mailing Address - Phone:917-825-1008
Mailing Address - Fax:718-336-0867
Practice Address - Street 1:1447 E 17TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-6703
Practice Address - Country:US
Practice Address - Phone:917-825-1008
Practice Address - Fax:718-336-0867
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006324133N00000X
NY940576133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2838280OtherUNITED HEALTH CARE
NYP3865850OtherOXFORD PROVIDER NUMBER