Individual
JANE PROKOPOWICZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MBA MS RD CDN
Contact information
Practice address
29 POLO RD, MASSAPEQUA, NY 11758-5937
(516) 798-2934
Mailing address
29 POLO ROAD, MASSAPEQUA, NY 11758
(516) 798-2934
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
563893
NY
Other
Enumeration date
02/25/2009
Last updated
10/03/2011
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