Organization
SIMNUTRITION INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEFANIA MEDVEDIK RD, RN, CDE (OWNER)
(646) 320-3244
Entity
Organization
Contact information
Practice address
34 ROWAN ST, SMITHTOWN, NY 11787-1057
(631) 406-7768
Mailing address
34 ROWAN ST, SMITHTOWN, NY 11787-1057
(631) 406-7768
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1096652
NY
163W00000X
Registered Nurse
6000881
NY
163WD0400X
Diabetes Educator Registered Nurse
21510265
NY
Other
Enumeration date
05/10/2018
Last updated
05/10/2018
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