Provider Demographics
NPI:1841593134
Name:CHUSID, LINDA J (RD, CDN)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:J
Last Name:CHUSID
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 1:39 WALLACE DR
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-2911
Mailing Address - Country:US
Mailing Address - Phone:516-932-6345
Mailing Address - Fax:516-932-1574
Practice Address - Street 1:39 WALLACE DR
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-2911
Practice Address - Country:US
Practice Address - Phone:516-932-6345
Practice Address - Fax:516-932-1574
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000997-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered