Provider Demographics
NPI:1669881090
Name:SYED, IMRAN (RDN, CDN)
Entity type:Individual
Prefix:
First Name:IMRAN
Middle Name:
Last Name:SYED
Suffix:
Gender:M
Credentials:RDN, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 GARDENIA LN
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-2008
Mailing Address - Country:US
Mailing Address - Phone:718-781-0683
Mailing Address - Fax:
Practice Address - Street 1:9 GARDENIA LN
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-2008
Practice Address - Country:US
Practice Address - Phone:718-781-0683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-11
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY932090133VN1006X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic