Provider Demographics
NPI:1760015770
Name:RUHNAU, MICHAEL (RD, CDN)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:RUHNAU
Suffix:
Gender:M
Credentials:RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 HASKELL AVE APT A
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-3811
Mailing Address - Country:US
Mailing Address - Phone:516-287-0823
Mailing Address - Fax:
Practice Address - Street 1:30 HASKELL AVE APT A
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-3811
Practice Address - Country:US
Practice Address - Phone:516-287-0823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-18
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009842-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered