Individual
MARIE S THEAGENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
320 E 94TH ST, NEW YORK, NY 10128-5604
(929) 613-1573
Mailing address
320 E 94TH ST, NEW YORK, NY 10128-5604
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1035387
—
Other
Enumeration date
03/29/2022
Last updated
07/13/2022
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