Individual
NICOLETTE DAVILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
365 E MAIN ST, PATCHOGUE, NY 11772-3145
(631) 866-2030
(631) 866-2033
Mailing address
P.O. BOX 5036, WHITE PLAINS, NY 10602-5036
(914) 734-8858
(914) 734-8786
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
133V00000X
Registered Dietitian
Primary
008301
NY
Other
Enumeration date
10/23/2017
Last updated
10/23/2017
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