Provider Demographics
NPI:1295246155
Name:TIMAUL, NEILAWATTIE MERNA
Entity type:Individual
Prefix:
First Name:NEILAWATTIE
Middle Name:MERNA
Last Name:TIMAUL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NEILAWATTIE
Other - Middle Name:MERNA
Other - Last Name:TIMAUL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3437 SEYMOUR AVE APT 4B
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-2180
Mailing Address - Country:US
Mailing Address - Phone:909-554-3326
Mailing Address - Fax:
Practice Address - Street 1:3437 SEYMOUR AVE APT 4B
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-2180
Practice Address - Country:US
Practice Address - Phone:917-596-8665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-18
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education