Individual
MRS. JENNIFER TAVERAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.,CDN,CDE
Contact information
Practice address
5514 MAIN ST, FLUSHING, NY 11355-5058
(516) 510-5769
Mailing address
829 PLAINFIELD LN, VALLEY STREAM, NY 11581-3608
(516) 510-5769
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
2011-0516
NY
133V00000X
Registered Dietitian
Primary
005680-1
NY
Other
Enumeration date
08/16/2007
Last updated
09/20/2011
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