MEDICARE: DAWN M MONTELION SCRIBNER M.S., R.D., C.D.E

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	817169
2	174H00000X	Health Educator	2221-0397

General Provider Information

NPI Number	:	1770809584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWN M MONTELION SCRIBNER M.S., R.D., C.D.E

Provider Business Mailing Address
First Line	:	10 HEALTHY WAY
Second Line	:
City	:	ELLENVILLE
State	:	NY
Zip	:	12428
Country	:	US
Telephone Number	:	845-210-3023
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 HEALTHY WAY
Second Line	:
City	:	ELLENVILLE
State	:	NY
Zip	:	12428-5612
Country	:	US
Telephone Number	:	845-210-3023
Fax Number	:

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

Provider Enumeration Date	:	04/19/2010
Last Update Date	:	04/19/2010

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