NPI 1003157546

Jenna Bannon, MSRDCDN

Practitioner Registered Dietitian Bay Shore, NY

Practice location

Address: 301 E Main St, Bay Shore, NY 11706-8408
Phone: (631) 968-3593
Mailing address: 202 Cassa Loop, Holtsville, NY 11742-2609

Registered specialties

Registered Dietitian Primary

Dietary & Nutritional Service Providers Taxonomy 133V00000X Licence 0074641 (NY)

Other Dietitian, Registered providers in New York →

Registry record

NPI: 1003157546
Entity type: Individual
Sex (as registered): Female
NPI issued: 8 Mar 2013
Record last updated: 8 Mar 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.