Individual
ILISA R YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, RD, CDN
Contact information
Practice address
401 E 88TH ST, SUITE 10E, NEW YORK, NY 10128-6605
(212) 860-4776
(212) 860-4776
Mailing address
401 E 88TH ST, SUITE 10E, NEW YORK, NY 10128-6605
(212) 860-4776
(212) 860-4776
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
002317
NY
133V00000X
Registered Dietitian
Primary
002317
NY
Other
Enumeration date
01/22/2009
Last updated
01/22/2009
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