Individual
MRS. DIANE IDELLE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.,C.D.N.
Contact information
Practice address
43 AUDEN AVE, MELVILLE, NY 11747-8130
(516) 526-5872
Mailing address
43 AUDEN AVE, MELVILLE, NY 11747-8130
(516) 526-5872
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
000772-1
NY
Other
Enumeration date
04/16/2008
Last updated
04/16/2008
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