Individual provider · NPI-1

Stephanie Aviles, CDN

Dietitian, Registered · Bronx, NY

NPI number1063093698
StatusActive
Last updated in NPPESJan 3, 2024

Details

NPI
1063093698
Entity type
Individual (NPI-1)
Name
Stephanie Aviles
Credential
CDN
Sex
Female
Sole proprietor
No
Enumeration date
Apr 15, 2021
Certification date
Jan 3, 2024
Last updated
Jan 3, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
133V00000X Dietitian, Registered86055945–Yes
133N00000X Nutritionist010478-01NY

Practice location

1065 Southern Blvd
Bronx, NY 10459-2417

Phone 718-589-2440

Mailing address

1065 Southern Blvd
Bronx, NY 10459-2417

Phone 718-589-2440

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