Healthcare Provider Details

I. General information

NPI: 1467986794
Provider Name (Legal Business Name): RUTHANNE LHOMMEDIEU RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2017
Last Update Date: 09/21/2022
Certification Date: 09/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 KING ST
OGDENSBURG NY
13669-1142
US

IV. Provider business mailing address

214 KING ST
OGDENSBURG NY
13669-1142
US

V. Phone/Fax

Practice location:
  • Phone: 315-393-3600
  • Fax:
Mailing address:
  • Phone: 315-393-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number832517
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number004748
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: