Provider Demographics
NPI:1124775986
Name:TABIB, LIMOR (RDN)
Entity type:Individual
Prefix:MISS
First Name:LIMOR
Middle Name:
Last Name:TABIB
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 BARNYARD LN
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2809
Mailing Address - Country:US
Mailing Address - Phone:516-996-6336
Mailing Address - Fax:516-767-2576
Practice Address - Street 1:22 S MARYLAND AVE
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-2913
Practice Address - Country:US
Practice Address - Phone:516-767-2576
Practice Address - Fax:516-767-0312
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered