MAVIS REN (NPI# 1295104172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295104172 |
| Entity Type | Individual |
| Full Name | MAVIS REN |
| Credential | RD |
| Practice Address |
9704 Sutphin Blvd Jamaica NY 11435-4721 |
| Mailing Address |
60 Madison Ave 5th Floor New York NY 10010-1600 |
| Practice Telephone | 7186577088 |
| Practice Fax Number | 7186577092 |
| Mailing Telephone | 2125452400 |
| Mailing Fax Number | 6463120481 |
| Enumeration Date | 2015-09-21 |
| Last Update Date | 2015-10-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 008461-1 | NY | Dietary & Nutritional Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00695941 | 05 |
| Street Address |
9704 SUTPHIN BLVD |
| City | JAMAICA |
| State | NY |
| Zip Code | 11435-4721 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023084571 | Kristen Denise Manter | Family Medicine | 9704 Sutphin Blvd, Jamaica, NY 11435-4721 | 2006-02-24 |
| 1114437019 | Joanne Schmidt | Nurse Practitioner | 9704 Sutphin Blvd, Jamaica, NY 11435-4721 | 2017-10-05 |
| 1659822963 | Community Healthcare Network Inc | Clinic/Center | 9704 Sutphin Blvd, Jamaica, NY 11435-4721 | 2016-10-21 |
| 1053769141 | Soney Tino Siriphone | Optometrist | 9704 Sutphin Blvd, Jamaica, NY 11435-4721 | 2016-05-30 |
| 1508222522 | Community Healthcare Network, Inc | Clinic/Center | 9704 Sutphin Blvd, Jamaica, NY 11435-4721 | 2016-01-06 |
| 1669845160 | Loveta Uche | Nurse Practitioner | 9704 Sutphin Blvd, Jamaica, NY 11435-4721 | 2015-11-05 |
| 1265825970 | Andrea Ciano | Family Medicine | 9704 Sutphin Blvd, Jamaica, NY 11435-4721 | 2015-03-05 |
| 1588056311 | Susann Cortes | Social Worker | 9704 Sutphin Blvd, Jamaica, NY 11435-4721 | 2015-03-03 |
| 1881097111 | Michelle Diaz | Social Worker | 9704 Sutphin Blvd, Jamaica, NY 11435 | 2014-10-01 |
| 1013325810 | Debra Goodman | Registered Nurse | 9704 Sutphin Blvd, Jamaica, NY 11435-4721 | 2014-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780284273 | Angela Abramov | Nurse Practitioner | 141-30 Pershing Creacsent Apt 3c, Jamaica, NY 11435 | 2020-10-26 |
| 1871114892 | Alternative Care Occupational Therapy, PC | Occupational Therapist | 149-16 Jamaica Ave, Jamaica, NY 11435 | 2020-04-30 |
| 1831737311 | Aminat Adams | Registered Nurse | 10753 Remitown Street, Jamaica, NY 11435 | 2019-12-16 |
| 1376180349 | Isabella Herold | Dietitian, Registered | 97-04 Sutphin Boulevard, Jamaica, NY 11435 | 2019-12-09 |
| 1235774654 | Angela Rose Torriero | Occupational Therapist | 90-36 150th Street, Jamaica, Queens, NY 11435 | 2019-11-08 |
| 1396386009 | Alexandra Mikyung Kim | Registered Nurse | 90-27 Sutphin Boulevard, Jamaica, NY 11435 | 2019-10-03 |
| 1043782097 | Louis E Krigger | Counselor | Restfull Nights Corporation, 106-38 150th St, Jamaica, NY 11435 | 2018-12-31 |
| 1407326093 | Syretta Henry | Social Worker | 90-27 Sutphin Blvd 5th Floor, Jamaica, NY 11435 | 2018-11-27 |
| 1972083277 | Debra Witherspoon-benders | Licensed Vocational Nurse | Samaritan Daytop Village 138-02 Queens Boulevard, Briarwood, NY 11435 | 2018-08-16 |
| 1982182895 | Emmanuel Oszwa Odigie | Respite Care | 148-13 Hillside Ave, 2nd Fl Briarwood, Briarwood, NY 11435 | 2018-08-02 |
| Find all providers in zip 11435 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427657873 | Shemelkhay Murdakhayev | Dietitian, Registered | 8008 135th St Apt 219, Jamaica, NY 11435-1009 | 2020-10-17 |
| 1376180349 | Isabella Herold | Dietitian, Registered | 97-04 Sutphin Boulevard, Jamaica, NY 11435 | 2019-12-09 |
| 1619484896 | Sara Arbesfeld | Dietitian, Registered | 8268 164th St Fl 2, Jamaica, NY 11432-1121 | 2018-01-09 |
| 1154851806 | Shirley Charm | Dietitian, Registered | 173-18 82ave, Jamaica, NY 11432 | 2017-06-15 |
| 1801168570 | Vets Inc. | Dietitian, Registered | 111-16 173rd Street, Jamaica, NY 11433 | 2012-01-27 |
| 1245454354 | Sandra Stein | Dietitian, Registered | Choices Women's Health Center, 147-32 Jamaica Avenue, Jamaica, NY 11435 | 2007-04-12 |
| 1033154562 | Cindy Dawn Mcgovern | Dietitian, Registered | 179 Linden Blvd, Jamaica, NY 11425-0001 | 2006-06-18 |
| 1275175671 | Kristina Markovic | Dietitian, Registered | 8268 164th St, Jamaica, NY 11432-1121 | 2019-10-17 |
| 1447808688 | Valerie Rosario | Dietitian, Registered | 8900 Van Wyck Expy, Jamaica, NY 11418-2832 | 2019-08-30 |
| 1164992368 | Kwee Peng Hong | Dietitian, Registered | 8268 164th St, Jamaica, NY 11432-1121 | 2018-11-29 |
| Find all providers in JAMAICA | ||||
Please comment or provide details below to improve the information on MAVIS REN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.