| Doctor Name: | TINA D ROSS |
| NPI Number: | 1073551180 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.C. |
| License Number: | 003818 |
| Business Practice Address: | 30 Hatfield Ln Suite 101 Goshen, NY - 109246766 |
| Business Phone Number: | 8452948134 |
| Business Fax Number: | 8452946486 |
| Mailing Address: | 2 Coates Dr, GOSHEN |
| State: | NY |
| Postal Code: | 109246758 |
| Phone Number: | 8456511400 |
| Fax Number: | 8456511512 |
| NPI Enumeration Date: | 06/02/2006 |
| NPI Last Update Date: | 09/27/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133VN1006X |
| License Number: | 003818 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | Nutrition, Metabolic |
| Taxonomy Definition: | |