Teladietitian

Specialty details in registry · Jericho, NY

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At a glance

471 North Broadway, 363, Jericho, NY 11753

NPPES record updated Feb 23, 2017. Public records can lag behind changes at a practice.

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Are you accepting new patients?
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Insurance participation and appointment availability are not established by these public records.

Practice location

471 North Broadway, 363
Jericho, NY 11753

Professional details: NPI, taxonomy & registry record

NPI1265971261

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 133V00000X
Enumeration date: Feb 23, 2017
Record updated: Feb 23, 2017

More registry details

Provider type: Organization · Type 2
Other reported name: <UNAVAIL>

Reported taxonomies and licenses

Specialty details in registry

133V00000X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

471 North Broadway, 363
Jericho, NY 11753

Phone: (917) 535-3626

Mailing address

471 N BROADWAY # 363

JERICHO, NY 117532106

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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