Healthcare Provider Details

I. General information

NPI: 1417278524
Provider Name (Legal Business Name): DANIELE MUNFORD R.D., LDN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2010
Last Update Date: 08/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 SLEEPY HOLLOW DR STE 200
MIDDLETOWN DE
19709-5841
US

IV. Provider business mailing address

430 GREENS BRANCH LN
SMYRNA DE
19977-1185
US

V. Phone/Fax

Practice location:
  • Phone: 302-898-7806
  • Fax: 302-378-9128
Mailing address:
  • Phone: 302-279-6282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberDN-0000255
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDN-0000255
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: