Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN1001X | Nutrition | 1590 | NY |
NPI | 1174598734 |
---|---|
Provider Name | Dr. Sebastian T. Caliendo |
First Address | West Babylon, NY 11704-7821 |
Second Address | West Babylon, NY 11704-7821 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2006 |
Last Update Date | 08/07/2007 |