Provider Demographics
NPI:1942649728
Name:JOSEPHS, CLAUDETTE V (RD)
Entity Type:Individual
Prefix:
First Name:CLAUDETTE
Middle Name:V
Last Name:JOSEPHS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6325 AUSTIN ST
Mailing Address - Street 2:SUITE 3B
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-2931
Mailing Address - Country:US
Mailing Address - Phone:917-207-6313
Mailing Address - Fax:
Practice Address - Street 1:6325 AUSTIN ST
Practice Address - Street 2:SUITE 3B
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2931
Practice Address - Country:US
Practice Address - Phone:917-207-6313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY613214133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered