Individual
JILLIAN GENOVESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
29 MIDLAND ST, COLD SPRING HARBOR, NY 11724-1826
(631) 935-5271
Mailing address
29 MIDLAND ST, COLD SPRING HARBOR, NY 11724-1826
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86253139
CDR REGISTRATION ID
NY
Enumeration date
10/24/2022
Last updated
10/24/2022
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