Individual
MYA ALEXIS LADIEU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN, CDN
Contact information
Practice address
55 CUTTERMILL RD, GREAT NECK, NY 11021-3259
(516) 851-0401
Mailing address
55 CUTTERMILL RD, GREAT NECK, NY 11021-3259
(516) 851-0401
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86329758
NY
Other
Enumeration date
10/23/2023
Last updated
10/23/2023
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