Individual
SAMANTHA LEVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
79 MIDDLEVILLE RD BLDG 200, NORTHPORT, NY 11768-2296
(631) 261-4400
Mailing address
1405 MILL RD, RONKONKOMA, NY 11779-1403
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
12/13/2022
Last updated
12/13/2022
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