Provider Demographics
NPI:1720896186
Name:BIG APPLE DIETETICS AND NUTRITION PLLC
Entity type:Organization
Organization Name:BIG APPLE DIETETICS AND NUTRITION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NAZIRBER
Authorized Official - Middle Name:
Authorized Official - Last Name:MADURO
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:929-307-0050
Mailing Address - Street 1:3080 N COURSE DR APT 304
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-3322
Mailing Address - Country:US
Mailing Address - Phone:347-898-6680
Mailing Address - Fax:
Practice Address - Street 1:11835 QUEENS BLVD STE 400
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-7211
Practice Address - Country:US
Practice Address - Phone:929-307-0050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-18
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered