Individual
JILL ERIKA DWORKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCHN
Contact information
Practice address
314 CHESTNUT HILL RD, GLASTONBURY, CT 06033-4153
(202) 270-5612
Mailing address
314 CHESTNUT HILL RD, GLASTONBURY, CT 06033-4153
(202) 270-5612
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MCC8099
MERCHANT CATEGORY CLASSIFICATION CODE
—
Enumeration date
12/14/2022
Last updated
12/14/2022
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