Individual
TEA GAVRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
60 ALCONA AVE, BUFFALO, NY 14226-2201
(716) 907-0994
Mailing address
60 ALCONA AVE, BUFFALO, NY 14226-2201
(716) 907-0994
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86036647
NY
Other
Enumeration date
06/17/2016
Last updated
06/17/2016
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