Individual
KIM MANFRIED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
400 SOUTH OYSTER ROAD, SUITE 300, HICKSVILLE, NY 11801-1180
(631) 203-8133
(833) 734-1553
Mailing address
30 WALTER CT, COMMACK, NY 11725-3602
(631) 852-1000
(833) 734-1553
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
10/28/2010
Last updated
05/24/2021
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