MEDICARE: MRS. KIUFONG MELISSA HON-TULCHINSKY MS, RD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133VN1006X	Metabolic Nutrition Registered Dietitian	845368	NY

General Provider Information

NPI Number	:	1154502714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KIUFONG MELISSA HON-TULCHINSKY MS, RD

Provider Business Mailing Address
First Line	:	255 LARK ST
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12210-1108
Country	:	US
Telephone Number	:	518-482-1570
Fax Number	:	518-482-5051

Provider Business Practice Location Address
First Line	:	255 LARK ST
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12210-1108
Country	:	US
Telephone Number	:	518-482-1570
Fax Number	:	518-482-5051

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/23/2007
Last Update Date	:	04/25/2014

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