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MS. BEVERLY BLOSSOM HERMALYN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.D.

Contact information

Practice address
79 MIDDLEVILE ROAD, NORTHPORT, NY 11768
(631) 261-4400
(631) 266-6018
Mailing address
79 MIDDLEVILLE RD, NORTHPORT, NY 11768-2200
(631) 261-4400

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary

Other

Enumeration date
10/03/2006
Last updated
11/12/2009
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