National Provider Identifier
Susan Edith Travis, PH.D.
Susan Edith Travis, PH.D. is listed in the NPPES registry with a primary specialty of Registered Dietitian in Ithaca, NY and a listed phone number of (607) 275-0224.
Profile Overview
- NPI
- 1649427261
- Provider Type
- Individual
- Primary Specialty
- Registered Dietitian
- Enumeration Date
- August 26, 2008
- Last Updated
- August 26, 2008
Practice Location
- 202 E State St
- Suite 402
- Ithaca, NY 14850-5551
Phone: (607) 275-0224
Specialties
- Registered Dietitian (133V00000X)
Full Record
- NPI
- 1649427261
- Entity Type
- Individual
- Last Name
- Travis
- First Name
- Susan
- Middle Name
- Edith
- Name Prefix
- Dr.
- Credential
- PH.D.
- Mailing Street Address
- 202 E State St
- Mailing Address Line 2
- Suite 402
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-5551
- Mailing Country
- US
- Mailing Phone
- (607) 275-0224
- Mailing Fax
- (607) 275-0224
- Practice Street Address
- 202 E State St
- Practice Address Line 2
- Suite 402
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-5551
- Practice Country
- US
- Practice Phone
- (607) 275-0224
- Practice Fax
- (607) 275-0224
- Enumeration Date
- August 26, 2008
- Last Updated
- August 26, 2008
- Sex
- Female
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Registered Dietitian (133V00000X)
- Other Identifiers
- 001553 (NY, New York State Certification), 718865 (NY, American Dietetic Association)