Individual
MS. JEANNETTE M BONVENTRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CDN
Contact information
Practice address
1300 ROANOKE AVE, RIVERHEAD, NY 11901-2031
(631) 548-6407
Mailing address
84 BAY RD, BROOKHAVEN, NY 11719-9746
(631) 803-0947
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
006215-1
NY
Other
Enumeration date
09/21/2006
Last updated
07/08/2007
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