Individual
REBECCA ETTEDGUI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-7151
Mailing address
10 W 66TH ST, 18C, NEW YORK, NY 10023-6206
(646) 662-7233
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
007135
NY
Other
Enumeration date
03/06/2011
Last updated
03/06/2011
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