Individual
JORINDA VIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2351 37TH ST, ASTORIA, NY 11105-1907
(630) 335-1623
Mailing address
2351 37TH ST, ASTORIA, NY 11105-1907
(630) 335-1623
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
008074
NY
Other
Enumeration date
10/08/2014
Last updated
10/08/2014
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