Provider Demographics
NPI:1073200085
Name:MARDINI, FATIMA (MS, RDN)
Entity type:Individual
Prefix:
First Name:FATIMA
Middle Name:
Last Name:MARDINI
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-4129
Mailing Address - Country:US
Mailing Address - Phone:808-940-3222
Mailing Address - Fax:
Practice Address - Street 1:1025 16TH AVE
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-4129
Practice Address - Country:US
Practice Address - Phone:808-940-3222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered