Provider Demographics
NPI:1316266299
Name:SEPE VIETS, ROSEMARY (MS,RD, CDN)
Entity type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:
Last Name:SEPE VIETS
Suffix:
Gender:F
Credentials:MS,RD, CDN
Other - Prefix:
Other - First Name:ROSEMARY
Other - Middle Name:
Other - Last Name:VIETS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS,RD,CDN
Mailing Address - Street 1:2160 POE AVENUE
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-5164
Mailing Address - Country:US
Mailing Address - Phone:516-384-1096
Mailing Address - Fax:
Practice Address - Street 1:68 MERRICK ROAD
Practice Address - Street 2:
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563
Practice Address - Country:US
Practice Address - Phone:516-384-1096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-18
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered