Doctor Name: | GWENDOLYN SHELLY |
NPI Number: | 1881998128 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.D. |
License Number: | 000747-1 |
Business Practice Address: | 6692 Middle Rd Suite 2100 Sodus, NY - 145519602 |
Business Phone Number: | 3154831199 |
Business Fax Number: | 3154832451 |
Mailing Address: | 14 Maiden Ln, P.o. Box 423 PENN YAN |
State: | NY |
Postal Code: | 145271208 |
Phone Number: | 3155319102 |
Fax Number: | 3155319103 |
NPI Enumeration Date: | 12/30/2010 |
NPI Last Update Date: | 12/30/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 000747-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |