Individual
STEPHANIE AVILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDN
Contact information
Practice address
1065 SOUTHERN BLVD, BRONX, NY 10459-2417
(718) 589-2440
Mailing address
1065 SOUTHERN BLVD, BRONX, NY 10459-2417
(718) 589-2440
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
010478-01
NY
133V00000X
Registered Dietitian
Primary
86055945
—
Other
Enumeration date
04/15/2021
Last updated
01/03/2024
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