Individual
MRS. EILEEN MCKENNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D., CDN
Contact information
Practice address
110 HORTON ST, MALVERNE, NY 11565-1513
(516) 812-5453
Mailing address
110 HORTON ST, MALVERNE, NY 11565-1513
(516) 812-5453
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
004863-1
NY
133V00000X
Registered Dietitian
Primary
714429
NY
Other
Enumeration date
08/15/2012
Last updated
08/15/2012
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