Individual
STACEY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN, CDN
Contact information
Practice address
15 DUANE AVE, NEW CITY, NY 10956-4943
(845) 548-8372
Mailing address
15 DUANE AVE, NEW CITY, NY 10956-4943
(845) 548-8372
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
011968
NY
Other
Enumeration date
03/07/2024
Last updated
03/07/2024
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