Provider Demographics
NPI:1720395296
Name:GRECO, NATALIE ROSE (RD, CDN, CDE)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:ROSE
Last Name:GRECO
Suffix:
Gender:F
Credentials:RD, CDN, CDE
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:ROSE
Other - Last Name:SWITALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:300 INTERNATIONAL DR STE 125
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5781
Mailing Address - Country:US
Mailing Address - Phone:716-572-4909
Mailing Address - Fax:716-710-7022
Practice Address - Street 1:300 INTERNATIONAL DR STE 125
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5781
Practice Address - Country:US
Practice Address - Phone:716-572-4909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-07
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1023951133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1023951OtherNATIONAL REGISTRATION-REGISTERED DIETITIAN