Organization
NAZ MADURO NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAZIRBER D MADURO RDN, CDN, CDCES (PRESIDENT)
(347) 898-6680
Entity
Organization
Contact information
Practice address
11835 QUEENS BLVD STE 400, FOREST HILLS, NY 11375-7211
(929) 307-0050
Mailing address
11835 QUEENS BLVD STE 400, FOREST HILLS, NY 11375-7211
(929) 307-0050
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03813283
—
NY
01
—
1306391586
NAZIRBER MADURO INDIVIDUAL NPI
NY
Enumeration date
08/03/2021
Last updated
02/28/2024
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