Individual
LISA D ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, CDN
Contact information
Practice address
1301 MAMARONECK AVE, WHITE PLAINS, NY 10605-5202
(914) 589-7962
(914) 761-3963
Mailing address
1301 MAMARONECK AVE, WHITE PLAINS, NY 10605-5202
(914) 589-7962
(914) 761-3963
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
165-1
NY
Other
Enumeration date
01/14/2007
Last updated
07/08/2007
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