Individual
RONI PAGANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12520 SUTPHIN BLVD, JAMAICA, NY 11434-2397
(718) 322-2136
Mailing address
126 TAFT AVE, LONG BEACH, NY 11561-3832
(516) 650-1407
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
000825
NY
133NN1002X
Nutrition Education Nutritionist
000825
NY
133V00000X
Registered Dietitian
000825
NY
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
000825
NY
Other
Enumeration date
01/08/2019
Last updated
01/08/2019
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