| NPI | 1235651027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA WONG Sole Proprietor 347-946-4245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NY 0065861) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2022-07-21 |