Provider Demographics
NPI:1164007266
Name:LARUE, ELIZABETH (RD)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:LARUE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 AMANN RD
Mailing Address - Street 2:
Mailing Address - City:HONEOYE FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14472-9705
Mailing Address - Country:US
Mailing Address - Phone:585-857-2771
Mailing Address - Fax:
Practice Address - Street 1:2655 RIDGEWAY AVENUE
Practice Address - Street 2:SUITE 220
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626
Practice Address - Country:US
Practice Address - Phone:585-368-4560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-10
Last Update Date:2023-12-29
Deactivation Date:2023-10-27
Deactivation Code:
Reactivation Date:2023-12-28
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered