Provider Demographics
NPI:1295589570
Name:MARAGH, ROHINI ANANDA (CN)
Entity type:Individual
Prefix:
First Name:ROHINI
Middle Name:ANANDA
Last Name:MARAGH
Suffix:
Gender:U
Credentials:CN
Other - Prefix:
Other - First Name:AZHARA
Other - Middle Name:
Other - Last Name:FARUQ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11640 197TH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:NY
Mailing Address - Zip Code:11412-3242
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11640 197TH ST
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:NY
Practice Address - Zip Code:11412-3242
Practice Address - Country:US
Practice Address - Phone:917-245-7835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist