Individual
STEPHEN WICKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD, CDN
Contact information
Practice address
340 WHEATLEY PLZ STE B, GREENVALE, NY 11548-1339
(516) 351-2350
Mailing address
340 WHEATLEY PLZ STE B, GREENVALE, NY 11548-1339
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
012331-01
NY
Other
Enumeration date
01/23/2025
Last updated
01/23/2025
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