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General NPI Number Information
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NPI Number | 1366727687
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Entity Type | Individual
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Provider Name | MARINA BEDROSSIAN RDN, CDN
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Gender | Female
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Dates
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Enumeration Date | 10/18/2011
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Last Update Date | 01/05/2017
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Provider Practice Location Address
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Address Line | 77 N WOODHULL RD
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City | HUNTINGTON
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State | NY
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Zip | 11743-2826
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Country | US
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Telephone | 631-374-6371
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Fax | 631-498-1174
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Provider Business Mailing Address
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Address Line | 77 N WOODHULL RD
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City | HUNTINGTON
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State | NY
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Zip | 11743-2826
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Country | US
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Telephone | 631-374-6371
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Fax | 631-498-1174
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 1066034
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License Number State | NY
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