Healthcare Provider Details

I. General information

NPI: 1316266299
Provider Name (Legal Business Name): ROSEMARY SEPE VIETS MS,RD, CDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ROSEMARY VIETS MS,RD,CDN

II. Dates (important events)

Enumeration Date: 05/18/2010
Last Update Date: 12/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 MERRICK ROAD
LYNBROOK NY
11563
US

IV. Provider business mailing address

2160 POE AVENUE
EAST MEADOW NY
11554-5164
US

V. Phone/Fax

Practice location:
  • Phone: 516-384-1096
  • Fax:
Mailing address:
  • Phone: 516-384-1096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: