Individual
STEVEN RYAN SURICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, RD, CDN
Contact information
Practice address
211 SADDLE ROCK RD, HOLBROOK, NY 11741-4809
(631) 560-1141
Mailing address
211 SADDLE ROCK RD, HOLBROOK, NY 11741-4809
(631) 560-1141
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
011086
NY
Other
Enumeration date
11/07/2022
Last updated
11/07/2022
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