Provider Demographics
NPI:1619213006
Name:MCNESS, RACHEL (MS, RD, CDN)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:MCNESS
Suffix:
Gender:F
Credentials:MS, RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 HASTINGS AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215-2914
Mailing Address - Country:US
Mailing Address - Phone:716-799-2555
Mailing Address - Fax:
Practice Address - Street 1:574 MAIN ST
Practice Address - Street 2:SUITE 203
Practice Address - City:EAST AURORA
Practice Address - State:NY
Practice Address - Zip Code:14052-1751
Practice Address - Country:US
Practice Address - Phone:716-608-3110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-12
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007639-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered