Individual
JACLYN A KIERNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
496 SMITHTOWN BYP STE 204, SMITHTOWN, NY 11787-5011
(631) 371-3825
Mailing address
496 SMITHTOWN BYP, SMITHTOWN, NY 11787-5005
(631) 406-9323
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86075293
—
Other
Enumeration date
04/06/2021
Last updated
08/02/2021
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