Individual
MRS. MARYANN FELICIA MASSILLIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPS,RDN,CDN,FAND
Contact information
Practice address
75 CRYSTAL RUN RD STE 201, MIDDLETOWN, NY 10941-7010
(845) 692-4391
Mailing address
75 CRYSTAL RUN RD STE 201, MIDDLETOWN, NY 10941-7010
(845) 692-4391
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
390200000X
NUTRITIONIST
NY
Enumeration date
06/11/2018
Last updated
06/11/2018
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