Healthcare Provider Details

I. General information

NPI: 1891973509
Provider Name (Legal Business Name): CYNTHIA ANN MILNER RD, MSED, CDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CINDY ANN MILNER RD, MSED, RD

II. Dates (important events)

Enumeration Date: 02/05/2008
Last Update Date: 02/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 WOODCREST AVE
ITHACA NY
14850-6241
US

IV. Provider business mailing address

66 WOODCREST AVE
ITHACA NY
14850-6241
US

V. Phone/Fax

Practice location:
  • Phone: 607-277-2049
  • Fax:
Mailing address:
  • Phone: 607-277-2049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: