Provider Demographics
NPI:1043312879
Name:TRULSEN, SUSAN L (RD REGISTERED DIETIT)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:L
Last Name:TRULSEN
Suffix:
Gender:F
Credentials:RD REGISTERED DIETIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 MAGDALEN RD
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054
Mailing Address - Country:US
Mailing Address - Phone:518-439-7077
Mailing Address - Fax:
Practice Address - Street 1:334 KRUMKILL RD
Practice Address - Street 2:
Practice Address - City:SLINGERLANDS
Practice Address - State:NY
Practice Address - Zip Code:12159
Practice Address - Country:US
Practice Address - Phone:518-935-4572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist