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Contact Information

ILEX C MA, MS, RD, CDN
1645 E 19TH ST
BROOKLYN, NY11229
 Phone: 347-556-7180
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dietitian, Registered

133V00000X 71 Registered Dietitian or Nutrition Professional
 

Nutritionist

133N00000X
Indicates primary specialty

NPI Profile & details for ILEX C MA · (Female)

NPI Number 1174892566
Status Active
Credentials MS, RD, CDN
Entity Individual
Enumeration date 12/14/2011
Last updated 07/13/2018 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 964083
  • NY License # 006403
  • IL Other 964083 COMMISSION ON DIETETIC REGISTRATION
  • NY Other 006403 THE UNIVERSITY OF THE STATE OF NEW YORK; EDUCATION DEPARTMENT
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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