Individual provider · NPI-1

Brooke Bucinell, RD,CDCES

Dietitian, Registered · Albany, NY

NPI number1245808104
StatusActive
Last updated in NPPESFeb 3, 2025

Details

NPI
1245808104
Entity type
Individual (NPI-1)
Name
Brooke Bucinell
Credential
RD,CDCES
Sex
Female
Sole proprietor
No
Enumeration date
Jun 16, 2021
Certification date
Feb 3, 2025
Last updated
Feb 3, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
133V00000X Dietitian, Registered86076678–Yes

Practice location

63 Shaker Rd Ste 201
Albany, NY 12204-1030

Phone 518-471-3636 · Fax 518-471-3668

Mailing address

Po Box 14890
Albany, NY 12212-4890

Other practice locations

855 Route 146 Ste 150
Clifton Park, NY 12065-3874

Phone 518-471-3636 · Fax 518-471-3668

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