Individual
DONNA MOODIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD CDE
Contact information
Practice address
1556 STRAIGHT PATH, WYANDANCH, NY 11798-3213
(631) 854-1700
Mailing address
22 GREENHAVEN WAY, CENTERPORT, NY 11721-1607
(631) 261-9739
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
896131
NY
Other
Enumeration date
09/16/2006
Last updated
07/08/2007
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