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General NPI Number Information
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NPI Number | 1982730875
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Entity Type | Individual
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Provider Name | CAROLYN GRZYWNA CDN
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Gender | Female
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1200 E AND WEST RD
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City | WEST SENECA
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State | NY
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Zip | 14224-3604
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Country | US
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Telephone | 716-517-2334
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Fax | 716-517-3652
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Provider Business Mailing Address
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Address Line | 58 BOLL ST
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City | SLOAN
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State | NY
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Zip | 14212-2211
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Country | US
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Telephone | 716-897-3420
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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 | 133VN1006X
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Taxonomy Name | Metabolic Nutrition Registered Dietitian
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License Number | 0050751
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License Number State | NY
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