Individual
MS. ELIZABETH O SHODIMU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICENSE
Contact information
Practice address
110-16 SUTPHIN BLVD, 111-08 WITTHOFF STREET, QUEEN'S VILLAGE, NY 11429
(917) 658-5068
Mailing address
111-08 WITTHOFF STREET, QUEEN'S VILLAGE, NY 11429
(917) 658-5068
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
004988-1
NY
133V00000X
Registered Dietitian
004988-1
NY
Other
Enumeration date
08/19/2015
Last updated
08/19/2015
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