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General NPI Number Information
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NPI Number | 1235439357
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Entity Type | Individual
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Provider Name | INNOCENTIA GIDI C.D.N
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Gender | Female
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Dates
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Enumeration Date | 10/22/2010
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Last Update Date | 10/22/2010
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Provider Practice Location Address
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Address Line | 1650 GRAND CONCOURSE
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City | BRONX
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State | NY
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Zip | 10457
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Country | US
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Telephone | 718-518-5290
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Fax |
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Provider Business Mailing Address
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Address Line | 1601 METROPOLITAN AVE 3C
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City | BRONX
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State | NY
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Zip | 10462
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Country | US
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Telephone | 347-263-6372
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | 005120
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License Number State | NY
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