Individual
MRS. MARCELLA BARBOUR FIACCO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MS RD CDN
Contact information
Practice address
1523 COLUMBIA TURNPIKE, SERENITY DAY SPA, CASTLETON, NY 12033
(518) 479-1433
(518) 479-1433
Mailing address
2536 FAWN RIDGE, CASTLETON, NY 12033
(518) 479-1433
(518) 479-1433
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
0026991
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10106803
CDPHP
NY
01
—
381226
MVP
NY
01
—
8000017131
AETNA
NY
Enumeration date
05/15/2006
Last updated
07/08/2007
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