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General NPI Number Information
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NPI Number | 1457358483
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Entity Type | Individual
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Provider Name | ALISUN JEAN DAUS RD
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Gender | Female
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Dates
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Enumeration Date | 07/06/2005
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Last Update Date | 07/21/2011
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Provider Practice Location Address
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Address Line | 47 NEW SCOTLAND AVE
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City | ALBANY
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State | NY
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Zip | 12208-3412
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Country | US
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Telephone | 518-262-6888
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Fax |
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Provider Business Mailing Address
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Address Line | 1230 ESPERANCE RD
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City | ESPERANCE
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State | NY
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Zip | 12066-2312
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Country | US
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Telephone | 518-878-6906
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 950241
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License Number State | NY
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