MEDICARE: MRS. JULIA E DURFEE RD, CDN

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	1050255	NY

General Provider Information

NPI Number	:	1710326632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JULIA E DURFEE RD, CDN

Provider Business Mailing Address
First Line	:	2765 N FOREST RD
Second Line	:	APT. A
City	:	GETZVILLE
State	:	NY
Zip	:	14068-1533
Country	:	US
Telephone Number	:	716-912-4558
Fax Number	:

Provider Business Practice Location Address
First Line	:	2765 N FOREST RD
Second Line	:	APT. A
City	:	GETZVILLE
State	:	NY
Zip	:	14068-1533
Country	:	US
Telephone Number	:	716-912-4558
Fax Number	:

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

Provider Enumeration Date	:	06/25/2013
Last Update Date	:	06/25/2013

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