Individual
MRS. MARY CATES JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
391 MYRTLE AVE STE 2, ALBANY, NY 12208-3797
(518) 262-4942
Mailing address
18 RURAL PL, DELMAR, NY 12054-1104
(518) 428-1405
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86049965
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141338310
—
NY
Enumeration date
09/13/2017
Last updated
03/17/2018
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