Janelle Edwards, RD, CDN, MS

Individual provider Active NPI Registered Dietitian · Tupper Lake, NY

NPI 1003570490 · NPPES record last updated Oct 22, 2021

Key facts

NPI
1003570490
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
86085288 (NY)
Practice address
3 Woodrow Ave
Tupper Lake, NY 12986-1008
Phone
(518) 524-7610
NPI assigned
Oct 22, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
86085288NYMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86085288 NY Yes

Addresses

Primary practice location

3 Woodrow Ave
Tupper Lake, NY 12986-1008

Mailing address

3 Woodrow Ave
Tupper Lake, NY 12986-1008
Phone (518) 524-7610

Other providers in Tupper Lake, NY

All providers in Tupper Lake, NY · Registered Dietitian in New York

Sources for this page

Verify at the official NPI Registry.