Provider Demographics
NPI:1871882746
Name:LUWISH, MICHELLE CHERNIN (MSRD)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:CHERNIN
Last Name:LUWISH
Suffix:
Gender:F
Credentials:MSRD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 SOUTH MONSEY RD.
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952
Mailing Address - Country:US
Mailing Address - Phone:845-352-3735
Mailing Address - Fax:
Practice Address - Street 1:12 S MONSEY RD
Practice Address - Street 2:
Practice Address - City:AIRMONT
Practice Address - State:NY
Practice Address - Zip Code:10952-4417
Practice Address - Country:US
Practice Address - Phone:845-352-3735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-31
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14700133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered