Most Relevant Information
Provider Data
| NPI Number: | 1003448085 |
| Provider Name: | MARIANA OLGA SERBACK MS, RDN |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 86050685 |
Most Important Dates
| Enumeration Date: | 02/07/2020 |
| Last Updated: | 02/07/2020 |
Provider Practice Location
19500 WOODSIDE DR
WATERTOWN
NY
136014458
Practice Location Phone/Fax
| Phone: | 3157789218 |
| Fax: |
Provider Mailing Location
19500 WOODSIDE DR
WATERTOWN
NY
136014458
Provider Mailing Phone/Fax
| Phone: | 3157789218 |
| Fax: |