Individual
MINERVA KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
101 NORTHERN BLVD, GREENVALE, NY 11548-1340
(516) 563-7940
Mailing address
101 NORTHERN BLVD, GREENVALE, NY 11548-1340
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
NY
Other
Enumeration date
01/05/2022
Last updated
09/05/2024
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