Individual
MRS. JENNY MARIE FADDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CDN, CNSC
Contact information
Practice address
12 LOUNSBURY DR, BALDWIN PLACE, NY 10505-1001
(914) 815-8131
Mailing address
12 LOUNSBURY DR, BALDWIN PLACE, NY 10505-1001
(914) 815-8131
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
006928
NY
Other
Enumeration date
10/29/2021
Last updated
10/29/2021
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