Individual
MARIAH LEE PETRUSEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.N.
Contact information
Practice address
4330 MAPLE RD, BUFFALO, NY 14226-1064
(716) 348-0057
Mailing address
134 NORTH AVE, WEST SENECA, NY 14224-1328
(716) 348-0057
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
011535-01
NY
Other
Enumeration date
11/28/2023
Last updated
07/17/2024
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