Provider Demographics
NPI:1205415759
Name:DUTCHESS DIETETICS, LLC
Entity Type:Organization
Organization Name:DUTCHESS DIETETICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:KELLY
Authorized Official - Last Name:GRAZIANO
Authorized Official - Suffix:
Authorized Official - Credentials:RD, CDN, CDCES
Authorized Official - Phone:347-525-4758
Mailing Address - Street 1:PO BOX 609
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-0609
Mailing Address - Country:US
Mailing Address - Phone:845-444-1021
Mailing Address - Fax:
Practice Address - Street 1:6571 SPRING BROOK AVE
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-3711
Practice Address - Country:US
Practice Address - Phone:845-444-1021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-02
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service