Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MARLO NANCI MITTLER, MS RD
Active Sole ProprietorPediatric Nutrition · GREAT NECK, NY
Registration Details
- NPI Number
- 1194398156
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jul 19, 2021 (4.769857802117 yrs)
- Last Updated
- Jul 19, 2021
- Licenses
-
819264 (NY)819264 (NY)819264 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
173 E SHORE RDGREAT NECK, NY, 110232456Browse NY providers · Browse ZIP 11023
- Phone
- 5168576465
- Primary Specialty
-
Pediatric Nutrition
133VN1004X
- Additional Specialty
- Pediatric Nutrition
- Additional Specialty
- Pediatric Nutrition
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.