Provider Demographics
NPI:1548442742
Name:LIJOI, MARIA CATHERINE (RD)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:CATHERINE
Last Name:LIJOI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43750 GARFIELD RD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-1135
Mailing Address - Country:US
Mailing Address - Phone:586-228-4652
Mailing Address - Fax:586-228-4533
Practice Address - Street 1:45660 SCHOENHERR RD
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48315-6033
Practice Address - Country:US
Practice Address - Phone:586-226-6843
Practice Address - Fax:586-566-3068
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI932504133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI932504OtherCERTIFICATION
MI0N55210Medicare PIN