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General NPI Number Information
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NPI Number | 1043312879
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Entity Type | Individual
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Provider Name | SUSAN L TRULSEN RD REGISTERED DIETIT
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Gender | Female
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Dates
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Enumeration Date | 09/02/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 334 KRUMKILL RD
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City | SLINGERLANDS
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State | NY
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Zip | 12159
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Country | US
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Telephone | 518-935-4572
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Fax |
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Provider Business Mailing Address
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Address Line | 22 MAGDALEN RD
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City | DELMAR
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State | NY
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Zip | 12054
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Country | US
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Telephone | 518-439-7077
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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