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Individual

LISA MODESTI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
20 BIRLING GAP, FAIRPORT, NY 14450-3916
(585) 729-9364
Mailing address
20 BIRLING GAP, FAIRPORT, NY 14450-3916
(585) 729-9364

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
718852
NY

Other

Enumeration date
09/29/2015
Last updated
09/29/2015
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