Basic Information
| Provider Information | |||||||||
| NPI: | 1962766592 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VARTHIS | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MS, RD, CSO, CDN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 WOODBURY CT | ||||||||
| Address2: | |||||||||
| City: | HICKSVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 118013159 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5169379194 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 237 JERICHO TPKE | ||||||||
| Address2: | |||||||||
| City: | SYOSSET | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117914513 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5165846400 | ||||||||
| FaxNumber: | 5165846401 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2012 | ||||||||
| LastUpdateDate: | 06/28/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133N00000X | 007116 | NY | N | Dietary & Nutritional Service Providers | Nutritionist | 133V00000X | 992912 | NY | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.