Organization
NY-PENN NUTRITION SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTINA ANNE HASEMANN PH.D, R.D. (PRESIDENT/CEO)
(607) 770-6221
Entity
Organization
Contact information
Practice address
74 LA GRANGE ST, BINGHAMTON, NY 13905-1718
(607) 770-6221
(607) 770-6221
Mailing address
74 LA GRANGE ST, BINGHAMTON, NY 13905-1718
(607) 770-6221
(607) 770-6221
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
000732
NY
251B00000X
Case Management Agency
Primary
804448 (R DIETITIAN)
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1669539284
NPI
—
Enumeration date
01/19/2009
Last updated
01/19/2009
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