Individual
SISSELL GAVIOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
9124 90TH ST, WOODHAVEN, NY 11421-3017
(347) 922-1126
Mailing address
9124 90TH ST, WOODHAVEN, NY 11421-3017
(347) 922-1126
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86167791
NY
Other
Enumeration date
09/27/2023
Last updated
09/27/2023
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