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General NPI Number Information
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NPI Number | 1497068738
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Entity Type | Individual
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Provider Name | DEBORAH C. JARRY CDN
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Gender | Female
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Dates
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Enumeration Date | 07/15/2010
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Last Update Date | 07/15/2010
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Provider Practice Location Address
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Address Line | 8 DYCKMAN DR
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City | MOHEGAN LAKE
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State | NY
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Zip | 10547-1851
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Country | US
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Telephone | 914-526-6167
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Fax |
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Provider Business Mailing Address
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Address Line | 1137 ROUTE 216
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City | POUGHQUAG
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State | NY
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Zip | 12570-5620
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Country | US
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Telephone | 845-518-2164
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Fax | 845-478-2069
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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 | 004204-1
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License Number State | NY
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