Individual
MRS. EILEEN SUSAN FICCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA ,CDN
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-7071
Mailing address
2540 SHORE BLVD, 4J, ASTORIA, NY 11102-3941
(718) 278-5136
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
004108-1
NY
Other
Enumeration date
06/20/2011
Last updated
06/20/2011
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