Provider Demographics
NPI:1720672264
Name:BIBLOWIT, JULIE CANNOLD (RD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:CANNOLD
Last Name:BIBLOWIT
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 1:167 E 67TH ST APT 14C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-5920
Mailing Address - Country:US
Mailing Address - Phone:914-589-9662
Mailing Address - Fax:
Practice Address - Street 1:167 E 67TH ST APT 14C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-5920
Practice Address - Country:US
Practice Address - Phone:914-589-9662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered