Individual
SUSAN DESAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
79 MIDDLEVILLE ROAD, NORTHPORT, NY 11768
(631) 261-4400
Mailing address
208 WOODBINE AVENUE, NORTHPORT, NY 11768
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
10/04/2006
Last updated
07/08/2007
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