Individual
GRACE MAE BARTOLILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CDN
Contact information
Practice address
2 TITUS PL, WALTON, NY 13856-1455
(607) 865-2171
Mailing address
2 TITUS PL, WALTON, NY 13856-1455
(607) 865-2159
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
928918
NY
Other
Enumeration date
10/29/2021
Last updated
10/29/2021
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