Organization
CASA BULO NUTRITION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONCEPCION BULO RD, CDE (REGISTERED DIETITIAN)
(929) 322-4781
Entity
Organization
Contact information
Practice address
2145 28TH ST APT A3, ASTORIA, NY 11105-2943
(929) 322-4781
Mailing address
2145 28TH ST APT A3, ASTORIA, NY 11105-2943
(929) 322-4781
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
01/22/2021
Last updated
02/15/2021
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