Individual
MAEDA MIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
11835 QUEENS BLVD STE 400, FOREST HILLS, NY 11375-7211
(929) 307-0050
Mailing address
2 JUNEAU BLVD, WOODBURY, NY 11797
(347) 233-9588
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
08/17/2021
Last updated
04/20/2024
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