Individual
ROSEANNE NENNINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ND
Contact information
Practice address
115 RANDALL AVE, PORT JEFFERSON, NY 11777-1638
(631) 834-2502
Mailing address
115 RANDALL AVE, PORT JEFFERSON, NY 11777-1638
(631) 834-2502
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
3866
NY
Other
Enumeration date
01/19/2020
Last updated
01/19/2020
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