Individual
CONCEPCION ALEJANDRA BULO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, CDN, CLC
Contact information
Practice address
3611 21ST ST, LONG ISLAND CITY, NY 11106-4705
(718) 482-7772
(718) 482-9648
Mailing address
60 MADISON AVE FL 5, NEW YORK, NY 10010-1600
(212) 545-2439
(646) 312-0481
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
009023
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00695941
—
NY
Enumeration date
07/10/2017
Last updated
10/22/2024
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