Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | X0067441 | NY |
NPI | 1417137654 |
---|---|
Provider Name | Dr. Rona Yvelyse Allen |
First Address | New York, NY 10150-6139 |
Second Address | Blauvelt, NY 10960 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2007 |
Last Update Date | 28/08/2014 |