Individual
RUSANA BOROCHOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
6933 170TH ST, FRESH MEADOWS, NY 11365-3309
(718) 591-1610
Mailing address
6933 170TH ST, FRESH MEADOWS, NY 11365-3309
(718) 591-1610
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
00979712
NY
Other
Enumeration date
06/22/2009
Last updated
06/22/2009
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