Provider Demographics
NPI:1245549716
Name:LADOVSKY, RADMILA (RD, CDN)
Entity type:Individual
Prefix:
First Name:RADMILA
Middle Name:
Last Name:LADOVSKY
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 1:3064 CONEY ISLAND AVE
Mailing Address - Street 2:APT 6 C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6475
Mailing Address - Country:US
Mailing Address - Phone:718-483-0050
Mailing Address - Fax:718-743-1946
Practice Address - Street 1:3064 CONEY ISLAND AVE
Practice Address - Street 2:APT 6 C
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6475
Practice Address - Country:US
Practice Address - Phone:718-483-0050
Practice Address - Fax:718-743-1946
Is Sole Proprietor?:No
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006984-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered