Individual
MRS. JILLIAN ALEXANDRA KUBALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
38 S COUNTRY RD, WESTHAMPTON, NY 11977-1413
(631) 871-9856
Mailing address
38 S COUNTRY RD, WESTHAMPTON, NY 11977-1413
(631) 871-9856
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86058432
NY
Other
Enumeration date
09/08/2016
Last updated
09/08/2016
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