Healthcare Provider Details

I. General information

NPI: 1003995036
Provider Name (Legal Business Name): AMY CLIFFORD-CARTWRIGHT RD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY CARTWRIGHT RDN

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 08/28/2020
Certification Date: 08/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 MULBERRY ST
SCRANTON PA
18510-6800
US

IV. Provider business mailing address

100 NORTH ACADEMY AVE
DANVILLE PA
17822-4903
US

V. Phone/Fax

Practice location:
  • Phone: 570-703-8084
  • Fax:
Mailing address:
  • Phone: 570-271-6144
  • Fax: 570-271-6578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDN000747
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: