Individual
ALTANAH MIRIAM CORELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPN, RD, CDE
Contact information
Practice address
2001 5TH AVE, SUITE 110, TROY, NY 12180-3482
(518) 687-1960
(518) 687-1970
Mailing address
2001 5TH AVE, SUITE 110, TROY, NY 12180-3482
(518) 687-1960
(518) 687-1970
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
004680
NY
163W00000X
Registered Nurse
632682
NY
Other
Enumeration date
10/08/2015
Last updated
10/08/2015
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