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General NPI Number Information
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NPI Number | 1710023981
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Entity Type | Individual
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Provider Name | ANDREA BARON YURKEW RD, CDE
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Gender | Female
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 08/28/2015
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Provider Practice Location Address
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Address Line | 124 MAIN ST STE 6A
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City | HUNTINGTON
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State | NY
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Zip | 11743-6922
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Country | US
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Telephone | 631-754-6916
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Fax | 631-754-6916
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Provider Business Mailing Address
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Address Line | 124 MAIN ST SUITE 6A
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City | HUNTINGTON
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State | NY
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Zip | 11743-6922
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Country | US
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Telephone | 631-754-6916
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Fax | 631-754-6916
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 003711-1
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License Number State | NM
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