Provider Demographics
NPI:1831890698
Name:THURAU, SHELBI A (RD)
Entity type:Individual
Prefix:
First Name:SHELBI
Middle Name:A
Last Name:THURAU
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 PENN DR
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-2050
Mailing Address - Country:US
Mailing Address - Phone:631-374-1124
Mailing Address - Fax:
Practice Address - Street 1:32 PENN DR
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2050
Practice Address - Country:US
Practice Address - Phone:631-374-1124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered