Provider Demographics
NPI:1972138501
Name:SCHWARTZ, VICTORIA L (RDN)
Entity Type:Individual
Prefix:MISS
First Name:VICTORIA
Middle Name:L
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:MISS
Other - First Name:VICTORIA
Other - Middle Name:L
Other - Last Name:SCHWARTZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RDN
Mailing Address - Street 1:206 E JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-7330
Mailing Address - Country:US
Mailing Address - Phone:631-847-0200
Mailing Address - Fax:631-847-3525
Practice Address - Street 1:206 E JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-7330
Practice Address - Country:US
Practice Address - Phone:631-847-0200
Practice Address - Fax:631-847-3525
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered