Individual
MIKAELA CLEMENTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CDN
Contact information
Practice address
825 OCEAN AVE, WEST ISLIP, NY 11795-1413
(717) 615-5126
Mailing address
825 OCEAN AVE, WEST ISLIP, NY 11795-1413
(717) 615-5126
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86131183
NY
Other
Enumeration date
12/04/2020
Last updated
12/07/2020
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