Provider Demographics
NPI:1124428495
Name:MITTELMAN-SZANZER, ERICA (MS, RD, CDN, CDCES)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:MITTELMAN-SZANZER
Suffix:
Gender:F
Credentials:MS, RD, CDN, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 E 34TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-4819
Mailing Address - Country:US
Mailing Address - Phone:347-578-5112
Mailing Address - Fax:
Practice Address - Street 1:678 EASTERN PKWY APT 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-3311
Practice Address - Country:US
Practice Address - Phone:929-260-1661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-24
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY86024572133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered