Individual
SIRIDA SUBUDOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
1000 10TH AVE RM 2B-05, NEW YORK, NY 10019-1147
(212) 523-6733
Mailing address
700 GROVE ST APT 9P, JERSEY CITY, NJ 07310-1273
(845) 300-9648
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
01/31/2020
Last updated
01/31/2020
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