Organization
ELIZABETH MADISON NUTRITION, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH M MADISON RD (CEO)
(855) 958-9958
Entity
Organization
Contact information
Practice address
13333 BROOKVILLE BOULEVARD, SUITE 229C, ROSEDALE, NY 11422
(855) 958-9958
(855) 947-3783
Mailing address
22919 MERRICK BLVD, #226, LAURELTON, NY 11413-2108
(718) 276-6037
(855) 947-3783
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
00800548
NY
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
03/23/2015
Last updated
10/16/2019
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