Healthcare Provider Details

I. General information

NPI: 1235700071
Provider Name (Legal Business Name): GRACE C BELL DCN, CNS, CDN, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2021
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 BLACKBERRY DR
BREWSTER NY
10509-4113
US

IV. Provider business mailing address

112 BLACKBERRY DR
BREWSTER NY
10509-4113
US

V. Phone/Fax

Practice location:
  • Phone: 845-709-5232
  • Fax:
Mailing address:
  • Phone: 845-709-5232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number012174
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: