Individual
KACY ROMEO DISANTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2000 SHORE RD STE 104, LINWOOD, NJ 08221-2100
(609) 904-5627
Mailing address
94 SUNSET DR, MOUNT ROYAL, NJ 08061-1016
(856) 534-2935
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
Other
Enumeration date
10/22/2020
Last updated
10/23/2020
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