Individual
MRS. DOREEN MARY SIKOSCOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
2901 216TH ST, BAYSIDE, NY 11360-2810
(718) 281-8557
(718) 428-5936
Mailing address
2901 216TH ST, BAYSIDE, NY 11360-2810
(718) 281-8557
(718) 428-5936
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
001662
NY
133V00000X
Registered Dietitian
Primary
001662
NY
133VN1004X
Pediatric Nutrition Registered Dietitian
001662
NY
Other
Enumeration date
01/14/2009
Last updated
01/14/2009
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