National Provider Identifier
Mariah Lee Petrusek, R.D.N.
Mariah Lee Petrusek, R.D.N. is listed in the NPPES registry with a primary specialty of Registered Dietitian in Buffalo, NY and a listed phone number of (716) 348-0057.
Profile Overview
- NPI
- 1588430862
- Provider Type
- Individual
- Primary Specialty
- Registered Dietitian
- Enumeration Date
- November 28, 2023
- Last Updated
- July 17, 2024
Practice Location
- 4330 Maple RD
- Buffalo, NY 14226-1064
Phone: (716) 348-0057
Mailing Address
- 134 North Ave
- West Seneca, NY 14224-1328
Specialties
- Registered Dietitian (133V00000X)
Full Record
- NPI
- 1588430862
- Entity Type
- Individual
- Last Name
- Petrusek
- First Name
- Mariah
- Middle Name
- Lee
- Credential
- R.D.N.
- Mailing Street Address
- 134 North Ave
- Mailing City
- West Seneca
- Mailing State
- NY
- Mailing ZIP Code
- 14224-1328
- Mailing Country
- US
- Mailing Phone
- (716) 348-0057
- Practice Street Address
- 4330 Maple RD
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14226-1064
- Practice Country
- US
- Practice Phone
- (716) 348-0057
- Enumeration Date
- November 28, 2023
- Last Updated
- July 17, 2024
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- July 17, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Registered Dietitian (133V00000X)