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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

PHYLLIS RUSSELL, MS RD CDN

Active Sole Proprietor

Registered Dietitian · ROSEDALE, NY

Registration Details

NPI Number
1023772100
Provider Type
Individual
Gender
Female
NPI Issued
Oct 26, 2021 (4.4884760171672 yrs)
Last Updated
Oct 26, 2021
License
003127-01 (NY)
Sole Proprietor
Yes

Practice Information

Address
13519 242ND ST
ROSEDALE, NY, 114221521
Browse NY providers · Browse ZIP 11422
Phone
9176014575
Primary Specialty
Registered Dietitian
133V00000X
Additional Specialty
Registered Dietitian

Other Registered Dietitian Providers in ROSEDALE, NY

Name Credential NPI
MRS. ELIZABETH MARIE MADISON MA, RDN, CDN 1417293218
KAREN E NIMMONS RDN 1043854003
MS. ELISE GENEE HARRISON RDN 1275146615
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.