Organization
EATING DISORDER TREATMENT COLLABORATIVE/FEED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SONDRA KRONBERG MS,RD, CEDRD (DIRECTOR, OWNER)
(516) 513-1284
Entity
Organization
Contact information
Practice address
366 N BROADWAY, SUITE PHW-1, JERICHO, NY 11753-2025
(516) 513-1284
(516) 513-1285
Mailing address
366 N BROADWAY, SUITE PHW-1, JERICHO, NY 11753-2025
(516) 513-1284
(516) 513-1285
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
06/17/2014
Last updated
06/17/2014
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