Individual
CRYSTAL TINEO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CDN
Contact information
Practice address
51 KENSINGTON AVE, MERRICK, NY 11566-2331
(347) 255-6275
Mailing address
51 KENSINGTON AVE, MERRICK, NY 11566-2331
(347) 255-6275
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
008159-1
NY
133V00000X
Registered Dietitian
Primary
1055317
NY
Other
Enumeration date
01/30/2022
Last updated
01/30/2022
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