Individual
SANDRA FAIRWEATHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
42 7TH AVE, BROOKLYN, NY 11217-3412
(646) 330-5284
Mailing address
42 7TH AVE, BROOKLYN, NY 11217-3412
(646) 330-5284
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
48 004736
NY
Other
Enumeration date
06/20/2011
Last updated
06/20/2011
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