Individual
MICHELLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
221 JERICHO TPKE, SYOSSET, NY 11791-4515
(516) 496-2662
Mailing address
221 JERICHO TPKE, SYOSSET, NY 11791-4515
(516) 496-2662
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86073590
NY
Other
Enumeration date
10/17/2016
Last updated
10/17/2016
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