Provider Demographics
NPI:1053923144
Name:ASSAEL, JENNIFER S (RDN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:S
Last Name:ASSAEL
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14732 JAMAICA AVE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11435-4082
Mailing Address - Country:US
Mailing Address - Phone:718-349-9100
Mailing Address - Fax:718-349-9100
Practice Address - Street 1:14732 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-4082
Practice Address - Country:US
Practice Address - Phone:718-349-9100
Practice Address - Fax:718-349-9100
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education