MEDICARE: MRS. NATALIE ROBERTELLO 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	133V00000X	Registered Dietitian	007501	NY
2	133V00000X	Registered Dietitian	01043134	NY

General Provider Information

NPI Number	:	1659610756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NATALIE ROBERTELLO RD

Provider Business Mailing Address
First Line	:	16 FAIRCHILD DR
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14226-3327
Country	:	US
Telephone Number	:	315-368-3181
Fax Number	:

Provider Business Practice Location Address
First Line	:	3380 SHERIDAN DR # 317
Second Line	:
City	:	AMHERST
State	:	NY
Zip	:	14226-1439
Country	:	US
Telephone Number	:	716-249-2644
Fax Number	:	716-242-0030

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

Provider Enumeration Date	:	02/08/2013
Last Update Date	:	01/22/2021

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