Individual
MRS. DOROTHY MAY TRAIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6498 MOSSY BANK PARK RD, BATH, NY 14810-8165
(607) 776-7869
Mailing address
6498 MOSSY BANK PARK RD, BATH, NY 14810-8165
(607) 776-7869
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
0044341
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DD3771
MEDICARE PROVIDER NUMBER
NY
Enumeration date
01/29/2008
Last updated
01/29/2008
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