Individual
MS. SIMONE E NICOLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN CDN
Contact information
Practice address
1108 MARC DR, VALLEY STREAM, NY 11581-2536
(516) 837-7554
Mailing address
1108 MARC DR, VALLEY STREAM, NY 11581-2536
(516) 837-7554
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
48 006642
NY
133V00000X
Registered Dietitian
Primary
48 0066642
NY
Other
Enumeration date
01/25/2011
Last updated
11/28/2023
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