Doctor Name: | MRS. KATHERINE A ANDUZE |
NPI Number: | 1972894160 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CDN |
License Number: | 004249 |
Business Practice Address: | 3239 S Shelley St Mohegan Lake, NY - 105471909 |
Business Phone Number: | 9143337067 |
Business Fax Number: | |
Mailing Address: | 3239 S Shelley St, MOHEGAN LAKE |
State: | NY |
Postal Code: | 105471909 |
Phone Number: | 9143337067 |
Fax Number: | |
NPI Enumeration Date: | 04/22/2011 |
NPI Last Update Date: | 04/22/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133NN1002X |
License Number: | 004249 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Nutritionist |
Taxonomy Specialization: | Nutrition, Education |
Taxonomy Definition: |