Individual
ANNE E MCILHENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, CDE
Contact information
Practice address
133 PARK ST, MALONE, NY 12953-1220
(518) 483-3000
(518) 481-2695
Mailing address
133 PARK ST, MALONE, NY 12953-1220
(518) 483-3000
(518) 481-2695
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
002528-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002528-1
NYS REGISTRATION CERTIFIC
NY
01
—
00832652
AMERICAN DIETETIC ASSN #
—
01
—
DD0114
ALICE HYDE MEDICAL CENTER
NY
Enumeration date
05/15/2007
Last updated
12/04/2008
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