Individual
DANIELLE LEE DELUCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D., C.D.N.
Contact information
Practice address
301 E MAIN ST, BAY SHORE, NY 11706-8408
(631) 987-4978
Mailing address
122 LAKE ST, ISLIP, NY 11751-2038
(631) 987-4978
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1102158
NY
Other
Enumeration date
08/29/2012
Last updated
03/14/2013
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