Individual
MISS BERNICE RUTH PINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
1 BELLA VISTA DRIVE, ITHACA, NY 14850
(607) 375-6330
(607) 375-6301
Mailing address
P.O. BOX 383, DRYDEN, NY 13053
(607) 753-5061
(607) 756-3478
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
305324
—
Other
Enumeration date
06/09/2010
Last updated
06/09/2010
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