Individual
RIA REGINA EVANGELISTA EXALTACION MAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8268 164TH ST, JAMAICA, NY 11432-1121
(718) 883-3845
Mailing address
16410 WILLETS POINT BLVD, WHITESTONE, NY 11357-3335
(917) 216-7230
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
NY
Other
Enumeration date
01/05/2018
Last updated
01/05/2018
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