Individual
SOPHIA-JO BLAUVELT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
41 JOHN ST, BABYLON, NY 11702-2932
(631) 204-3375
Mailing address
10 ANDORRA LN, LAKE GROVE, NY 11755-2702
(781) 507-1119
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
11/29/2024
Last updated
11/29/2024
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