Provider Demographics
NPI:1134733793
Name:WOLZ, ALEXANDRIA MADISON (RD, CDN)
Entity type:Individual
Prefix:MS
First Name:ALEXANDRIA
Middle Name:MADISON
Last Name:WOLZ
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 1:236 E 106TH ST APT 5W
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-4022
Mailing Address - Country:US
Mailing Address - Phone:415-350-8027
Mailing Address - Fax:
Practice Address - Street 1:236 E 106TH ST APT 5W
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-4022
Practice Address - Country:US
Practice Address - Phone:415-350-8027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered