PHYLLIS RUSSELL

ROSEDALE, NY
NPI1023772100
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy133V00000X Dietitian, Registered
(Licence: NY  003127-01)
Additional Taxonomies133VN1101X Dietitian, Registered, Nutrition, Gerontological
133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management
Enumeration Date2021-10-26
Last Update Date2021-10-26
Business Address
PHYLLIS RUSSELL MS RD CDN
13519 242ND ST
ROSEDALE, NY 11422-1521
Phone number: 917-601-4575
Mailing Address
PHYLLIS RUSSELL MS RD CDN
13519 242ND ST
ROSEDALE, NY 11422-1521
Phone number: 917-601-4575