Individual
SAMANTHA JO FARELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
221 JERICHO TPKE, SYOSSET, NY 11791-4515
(516) 496-2662
(516) 496-2763
Mailing address
3 DEFEO CT, DEER PARK, NY 11729-1841
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86087288
NY
Other
Enumeration date
02/22/2019
Last updated
02/22/2019
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