Individual
KELLY ELAINE GUMPEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CDN, CDE
Contact information
Practice address
60 PAULDING AVE, TARRYTOWN, NY 10591-5713
(914) 280-0500
Mailing address
60 PAULDING AVE, TARRYTOWN, NY 10591-5713
(914) 280-0500
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
007906
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00695941
—
NY
Enumeration date
12/13/2013
Last updated
02/26/2019
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