Provider Demographics
NPI:1336391150
Name:ALPERT-JACOBS, JUNE (MS, RD, CDN)
Entity Type:Individual
Prefix:
First Name:JUNE
Middle Name:
Last Name:ALPERT-JACOBS
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 1:28 SYCAMORE DR
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-1418
Mailing Address - Country:US
Mailing Address - Phone:516-869-5563
Mailing Address - Fax:516-627-2425
Practice Address - Street 1:28 SYCAMORE DR
Practice Address - Street 2:
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-1418
Practice Address - Country:US
Practice Address - Phone:516-869-5563
Practice Address - Fax:516-627-2425
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-13
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002426-1133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist