Basic Information
| Provider Information | |||||||||
| NPI: | 1093372948 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KRAZIEM | ||||||||
| FirstName: | SABRIN | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | RD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2906 TANEY RD APT 2B | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212094025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7863575316 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5022 CAMPBELL BLVD | ||||||||
| Address2: | |||||||||
| City: | NOTTINGHAM | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212364969 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108703808 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/28/2019 | ||||||||
| LastUpdateDate: | 05/28/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | 86095566 | MD | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.