Individual
NOA BENJO VASSALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CDN
Contact information
Practice address
150 BROADHOLLOW RD STE 102, MELVILLE, NY 11747-4901
(516) 441-9013
(215) 776-0389
Mailing address
30 WALTER CT, COMMACK, NY 11725-3602
(516) 441-9013
(215) 776-0389
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
01081401
NY
Other
Enumeration date
02/20/2024
Last updated
02/20/2024
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