Individual
DYEANNE COLETTE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1901 1ST AVE, NEW YORK, NY 10029-7404
(212) 423-7591
Mailing address
1940 E TREMONT AVE, APT 3G, BRONX, NY 10462-5642
(718) 207-7733
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
Other
Enumeration date
09/11/2012
Last updated
09/11/2012
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