Individual
SAMANTHA VALLEJO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
3108 GULL AVE, MEDFORD, NY 11763-1731
(631) 294-2090
Mailing address
3108 GULL AVE, MEDFORD, NY 11763-1731
(631) 294-2090
Taxonomy
Speciality
Code
Description
License number
State
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
Primary
086073674
NY
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
086073674
—
Other
Enumeration date
08/09/2021
Last updated
08/09/2021
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