Provider Demographics
NPI:1760199145
Name:LITT, JENNA
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:LITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 POST DR
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-1122
Mailing Address - Country:US
Mailing Address - Phone:516-776-5885
Mailing Address - Fax:
Practice Address - Street 1:745 5TH AVE STE 500
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10151-0099
Practice Address - Country:US
Practice Address - Phone:347-265-1148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-03
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered