Organization
ILYSE SIMON RD, NUTRITION THERAPISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ILYSE SIMON RDN CDN (OWNER)
(845) 331-6381
Entity
Organization
Contact information
Practice address
231 CLINTON AVE, KINGSTON, NY 12401-5030
(845) 331-6381
Mailing address
231 CLINTON AVE, KINGSTON, NY 12401
(845) 331-6381
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
48006091
NY
Other
Enumeration date
05/05/2014
Last updated
05/05/2014
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