Individual
LORRAINE LACCETTI MONGIELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CDE, BC-ADM
Contact information
Practice address
200 BELLE TERRE RD, PORT JEFFERSON, NY 11777-1928
(631) 474-6430
(631) 474-6161
Mailing address
107 SOUTHERN BLVD, NESCONSET, NY 11767-1731
(631) 724-1929
(631) 474-6161
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
02/26/2007
Last updated
09/05/2008
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