Individual
STEFANIA MEDVEDIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, RN, CDE
Contact information
Practice address
34 ROWAN ST, SMITHTOWN, NY 11787-1057
(631) 406-7768
Mailing address
34 ROWAN ST, SMITHTOWN, NY 11787-1057
(631) 406-7768
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
01096652
NY
163W00000X
Registered Nurse
600088-1
NY
163WD0400X
Diabetes Educator Registered Nurse
21510265
NY
Other
Enumeration date
05/21/2018
Last updated
05/21/2018
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