Provider Demographics
NPI:1720964679
Name:ESHEL, MADISON (MS, RDN, CDN)
Entity type:Individual
Prefix:MISS
First Name:MADISON
Middle Name:
Last Name:ESHEL
Suffix:
Gender:F
Credentials:MS, RDN, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1837 THELMA AVE
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-3033
Mailing Address - Country:US
Mailing Address - Phone:516-395-1202
Mailing Address - Fax:
Practice Address - Street 1:1837 THELMA AVE
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-3033
Practice Address - Country:US
Practice Address - Phone:516-395-1202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01287001133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered