Organization
DIETITIANS OF NORTHERN NEW YORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ETOSHA FARMER RDN (OWNER)
(315) 486-6077
Entity
Organization
Contact information
Practice address
312 SHERMAN ST, WATERTOWN, NY 13601-3614
(315) 486-6077
(315) 486-6077
Mailing address
16358 STAR SCHOOL HOUSE RD, DEXTER, NY 13634-3094
(315) 486-6077
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
NY
Other
Enumeration date
11/13/2017
Last updated
11/13/2017
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