Individual
MS. LISA MARIE GENTILE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
55 SUNSET RD, BAY SHORE, NY 11706-7819
(516) 662-3801
Mailing address
55 SUNSET RD, BAY SHORE, NY 11706-7819
(516) 662-3801
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
867340
NY
Other
Enumeration date
11/25/2024
Last updated
11/25/2024
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