Provider Demographics
NPI:1679106199
Name:JOSEPH, CYNTHIA (NUTRITIONIST)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:NUTRITIONIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100-11 208TH STREET
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11429
Mailing Address - Country:US
Mailing Address - Phone:917-651-9289
Mailing Address - Fax:
Practice Address - Street 1:100-11 208TH STREET
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11429
Practice Address - Country:US
Practice Address - Phone:917-651-9289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-13
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133N00000XDietary & Nutritional Service ProvidersNutritionist