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Individual

BLAKE AMELIA BITTLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
18 W 21ST ST FL 4, NEW YORK, NY 10010-6923
(212) 645-6903
Mailing address
200 E 72ND ST APT 17G, NEW YORK, NY 10021-4542
(609) 439-1238

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86151549

Other

Enumeration date
04/14/2020
Last updated
04/14/2020
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Product
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