Provider Demographics
NPI:1588151781
Name:ADOLPHE, ZUGE CARMELLE (RDN & CDN & MS)
Entity type:Individual
Prefix:MRS
First Name:ZUGE
Middle Name:CARMELLE
Last Name:ADOLPHE
Suffix:
Gender:F
Credentials:RDN & CDN & MS
Other - Prefix:MRS
Other - First Name:ZUGE
Other - Middle Name:CARMELLE
Other - Last Name:ZAMOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, RDN, CDN
Mailing Address - Street 1:16 MIDDLE NECK RD # 2006
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-2357
Mailing Address - Country:US
Mailing Address - Phone:347-410-4023
Mailing Address - Fax:
Practice Address - Street 1:14210 HOOVER AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-2100
Practice Address - Country:US
Practice Address - Phone:347-410-4023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-13
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY976042133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered