Individual
KARINA SUSANNE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
2450 N WADING RIVER RD, WADING RIVER, NY 11792-1402
(631) 929-6200
Mailing address
2450 N WADING RIVER RD, WADING RIVER, NY 11792-1402
(631) 929-6200
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
011740
NY
Other
Enumeration date
01/25/2024
Last updated
01/25/2024
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