Provider Demographics
NPI:1952681348
Name:MUEDIN, LEYLA (RD)
Entity Type:Individual
Prefix:
First Name:LEYLA
Middle Name:
Last Name:MUEDIN
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 1:776 6TH AVE
Mailing Address - Street 2:SUITE 4B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-6354
Mailing Address - Country:US
Mailing Address - Phone:212-779-1744
Mailing Address - Fax:212-779-0891
Practice Address - Street 1:776 6TH AVE
Practice Address - Street 2:SUITE 4B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6354
Practice Address - Country:US
Practice Address - Phone:212-779-1744
Practice Address - Fax:212-779-0891
Is Sole Proprietor?:No
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6394518133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered