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Individual

LINDA GAVRIELOV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
10460 QUEENS BLVD, APT 22G, FOREST HILLS, NY 11375-7301
(917) 658-3012
Mailing address
256 GLENBROOK RD APT 41C, STAMFORD, CT 06906-2527
(917) 658-3012

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
001284
CT
133V00000X
Registered Dietitian
006739-1
NY
133V00000X
Registered Dietitian
Primary

Other

Enumeration date
04/17/2009
Last updated
02/19/2015
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