Phyllis Russell, MSRDCDN
Phyllis Russell, MSRDCDN is a Registered Dietitian OR Nutrition Professional in Rosedale, New York. Qualified in 1991, 35 years ago. Practices as a sole proprietor. Licensed in New York.
- Years since qualifying
- 35
- Licensed in
- NY
- In the registry since
- 2021
- Specialties on file
- 3
Practice location Address checks out
13519 242nd StRosedale, NY 11422-1521
Phone: (917) 601-4575
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Registered Dietitian (primary) | Taxonomy 133V00000X · Licence 003127-01 (NY) |
|---|---|
| Gerontological Nutrition Registered Dietitian | Taxonomy 133VN1101X |
| Obesity and Weight Management Nutrition Registered Dietitian | Taxonomy 133VN1201X |
Record details
| NPI number | 1023772100 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | MSRDCDN |
| Sole proprietor | Yes |
| NPI enumerated | October 26, 2021 |
| Last updated in NPPES | October 26, 2021 |
| Certification date | October 26, 2021 |
| Mailing address | 13519 242nd St, Rosedale, NY 11422-1521 |
Medicare enrollment
| Medicare specialty | REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL |
|---|---|
| Medical school | OTHER |
| Graduated | 1991 (35 years in practice) |
| Accepts Medicare assignment | Not indicated |
| Practice locations | 2 on file with Medicare |