| Eating Disorder Treatment Collaborative/feed | |
|
366 N Broadway Suite Phw-1 Jericho NY 11753-2025 | |
| (516) 513-1284 | |
| (516) 513-1285 |
| Full Name | Eating Disorder Treatment Collaborative/feed |
|---|---|
| Speciality | Dietitian, Registered |
| Location | 366 N Broadway, Jericho, New York |
| Authorized Official Name and Position | Sondra Kronberg (DIRECTOR, OWNER) |
| Authorized Official Contact | 5165131284 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eating Disorder Treatment Collaborative/feed 366 N Broadway Suite Phw-1 Jericho NY 11753-2025 Ph: (516) 513-1284 | Eating Disorder Treatment Collaborative/feed 366 N Broadway Suite Phw-1 Jericho NY 11753-2025 Ph: (516) 513-1284 |
| NPI Number | 1437563400 |
|---|---|
| Provider Enumeration Date | 06/17/2014 |
| Last Update Date | 06/17/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437563400 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
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