Individual
MIRIAM SAMUELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
30 HERRICK DR, LAWRENCE, NY 11559-1528
(516) 239-5030
Mailing address
30 HERRICK DR, LAWRENCE, NY 11559-1528
(929) 380-2324
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86156403
NY
Other
Enumeration date
05/01/2023
Last updated
05/01/2023
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