Provider Demographics
NPI:1053058008
Name:SEANNA YUEN-MARYEA, CERTIFIED DIETITIAN NUTRITIONIST, PLLC
Entity Type:Organization
Organization Name:SEANNA YUEN-MARYEA, CERTIFIED DIETITIAN NUTRITIONIST, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MS, RD, CDN, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:YUEN-MARYEA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, CDN
Authorized Official - Phone:646-229-7581
Mailing Address - Street 1:515 E 86TH ST APT 1603
Mailing Address - Street 2:
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty