Jillian Genovese

Individual provider Active NPI Registered Dietitian · Cold Spring Harbor, NY

NPI 1457078057 · NPPES record last updated Oct 24, 2022

Key facts

NPI
1457078057
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
Practice address
29 Midland St
Cold Spring Harbor, NY 11724-1826
Phone
(631) 935-5271
NPI assigned
Oct 24, 2022
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Yes

Addresses

Primary practice location

29 Midland St
Cold Spring Harbor, NY 11724-1826

Mailing address

29 Midland St
Cold Spring Harbor, NY 11724-1826

Other identifiers

IdentifierTypeStateIssuer
86253139OtherNYCDR REGISTRATION ID

Other providers in Cold Spring Harbor, NY

All providers in Cold Spring Harbor, NY · Registered Dietitian in New York

Sources for this page

Verify at the official NPI Registry.