Provider Demographics
NPI:1992303523
Name:YUEN-MARYEA, SEANNA (MS, RD, CDN)
Entity type:Individual
Prefix:MRS
First Name:SEANNA
Middle Name:
Last Name:YUEN-MARYEA
Suffix:
Gender:F
Credentials:MS, RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 E 86TH ST
Mailing Address - Street 2:APT 1603
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-7592
Mailing Address - Country:US
Mailing Address - Phone:646-229-7581
Mailing Address - Fax:
Practice Address - Street 1:515 E 86TH ST APT 1603
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-7592
Practice Address - Country:US
Practice Address - Phone:646-229-7581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008304-01133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered