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Individual

ILEX CHIH-HENG MA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, RD, CDN

Contact information

Practice address
1645 E 19TH ST, BROOKLYN, NY 11229
(347) 556-7180
Mailing address
450 GOWER ST, STATEN ISLAND, NY 10314-5263
(347) 556-7180

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
006403
NY
133V00000X
Registered Dietitian
Primary
964083
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
006403
THE UNIVERSITY OF THE STATE OF NEW YORK; EDUCATION DEPARTMENT
NY
01
964083
COMMISSION ON DIETETIC REGISTRATION
IL
Enumeration date
12/14/2011
Last updated
07/13/2018
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