Anderson, Jean Marie

Anderson, Jean Marie is an sole proprietor health care provider with primary practice located at 79 Middleville Rd , Northport NY 11768-2200. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Anderson, Jean Marie can be contacted via phone (631) 261-4400.

Contact Information

Primary practice address
79 Middleville Rd Northport NY 11768-2200
Phone: (631) 261-4400
Fax: (631) 266-6018
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 805573

Profile Details

NPI number 1750475315
LBN Legal business name Anderson, Jean Marie
Credentials RD, CDN,CDE,MS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 3rd, 2006
Last updated Nov 6th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750475315 NPPES
New York Other 000570-1 CERTIFIED DIETITIAN-NUTRI

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