Individual
INGRID DAGMAR ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD.
Contact information
Practice address
15 LONG LN, CAIRO, NY 12413-2509
15185330544
Mailing address
15 LONG LN, CAIRO, NY 12413-2509
15185330544
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
009132-1
NY
133V00000X
Registered Dietitian
6009617
NY
133V00000X
Registered Dietitian
86009617
NY
Other
Enumeration date
01/29/2015
Last updated
03/17/2018
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