Individual
MARLO NANCI MITTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS RD
Contact information
Practice address
173 E SHORE RD, GREAT NECK, NY 11023-2456
(516) 857-6465
Mailing address
5 COLONIAL DR, SMITHTOWN, NY 11787-4212
(516) 857-6465
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
819264
NY
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
819264
IL
133VN1004X
Pediatric Nutrition Registered Dietitian
819264
NY
Other
Enumeration date
07/19/2021
Last updated
07/19/2021
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