Individual provider · NPI-1

Sophia-Jo Blauvelt

Dietitian, Registered · Babylon, NY

NPI number1992521462
StatusActive
Last updated in NPPESNov 29, 2024

Details

NPI
1992521462
Entity type
Individual (NPI-1)
Name
Sophia-Jo Blauvelt
Sex
Female
Sole proprietor
No
Enumeration date
Nov 29, 2024
Certification date
Nov 29, 2024
Last updated
Nov 29, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
133V00000X Dietitian, Registered––Yes

Practice location

41 John St
Babylon, NY 11702-2932

Phone 631-204-3375

Mailing address

10 Andorra Ln
Lake Grove, NY 11755-2702

Phone 781-507-1119

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