Individual
MRS. REGINA BAKSHIYEV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CDN
Contact information
Practice address
13-51 RIVER RD STE B, FAIR LAWN, NJ 07410
(201) 398-0020
Mailing address
6 MCGUIRE CT, OLD BRIDGE, NJ 08857-4400
(732) 910-5862
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
984541
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006657-1
THE UNIVERSITY OF THE STATE OF NEW YORK, OFFICE OF THE PROFESSIONS
NY
Enumeration date
04/23/2008
Last updated
12/10/2018
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