Individual
JACLYN A KASSOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2053 BELLMORE AVE, BELLMORE, NY 11710-5603
(516) 679-1110
Mailing address
844 PRESTON RD, EAST MEADOW, NY 11554-4531
(516) 359-3689
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1059289
NY
Other
Enumeration date
09/12/2011
Last updated
09/12/2011
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