Individual
MS. ILYSE A SIMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CDN
Contact information
Practice address
231 CLINTON AVE, KINGSTON, NY 12401-5030
(845) 331-6381
Mailing address
231 CLINTON AVE, KINGSTON, NY 12401-8003
(845) 331-6381
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
006097
NY
Other
Enumeration date
06/22/2006
Last updated
04/25/2014
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