Individual
JENNA DECARLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 FOREST AVE APT 301, LOCUST VALLEY, NY 11560-2148
(516) 669-6653
Mailing address
300 FOREST AVE APT 301, LOCUST VALLEY, NY 11560-2148
(516) 669-6653
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86290638
NY
Other
Enumeration date
01/27/2025
Last updated
01/27/2025
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