Doctor Name: | MISS JENNIFER LYN FITZGIBBON |
NPI Number: | 1679866909 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS RD CDN |
License Number: | 0059291 |
Business Practice Address: | 3 Edmund D Pellegrino Rd Stony Brook, NY - 117941008 |
Business Phone Number: | 6316380851 |
Business Fax Number: | 6316380850 |
Mailing Address: | 3 Edmund D Pellegrino Rd, STONY BROOK |
State: | NY |
Postal Code: | 117941008 |
Phone Number: | 6316380851 |
Fax Number: | 6316380850 |
NPI Enumeration Date: | 05/19/2011 |
NPI Last Update Date: | 05/19/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 0059291 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |