Provider Demographics
NPI:1194959528
Name:TOMILOWICZ, LYNN MARIE (RD)
Entity type:Individual
Prefix:MS
First Name:LYNN
Middle Name:MARIE
Last Name:TOMILOWICZ
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 W 168TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3720
Mailing Address - Country:US
Mailing Address - Phone:212-305-7151
Mailing Address - Fax:
Practice Address - Street 1:7 BALINT DR
Practice Address - Street 2:APT. #221
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-3941
Practice Address - Country:US
Practice Address - Phone:914-274-7532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006710-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered