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Contact Information

ELIZABETH O SHODIMU, LICENSE
110-16 SUTPHIN BLVD
111-08 WITTHOFF STREET
QUEENS VILLAGE, NY11429
 Phone: 917-658-5068
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nutritionist

133N00000X
 

Dietitian, Registered

133V00000X 71 Registered Dietitian or Nutrition Professional
Indicates primary specialty

NPI Profile & details for ELIZABETH O SHODIMU · (Female)

NPI Number 1407222920
Status Active
Credentials LICENSE
Entity Individual
Enumeration date 08/19/2015
Last updated 08/19/2015 - About 11 years ago
Sole proprietor 1 Yes
Identifiers
  • NY License # 004988-1
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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