Individual
MRS. IMMA NORMATOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, CLC
Contact information
Practice address
9822 63RD DR APT 2E, REGO PARK, NY 11374-2301
(718) 532-6241
Mailing address
9822 63RD DR APT 2E, REGO PARK, NY 11374-2301
(718) 532-6241
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1091516
NY
Other
Enumeration date
12/08/2015
Last updated
12/08/2015
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