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General NPI Number Information
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NPI Number | 1750708079
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Entity Type | Individual
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Provider Name | MELISSA ANN DIMARINO RD, CDN
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Gender | Female
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Dates
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Enumeration Date | 03/25/2014
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Last Update Date | 07/16/2015
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Provider Practice Location Address
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Address Line | 6439 GARNERS FERRY RD
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City | COLUMBIA
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State | SC
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Zip | 29209-1638
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Country | US
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Telephone | 914-737-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 4207 ENCLAVE PARIS DR
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City | GREENVILLE
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State | SC
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Zip | 29609-1352
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Country | US
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Telephone | 914-419-3553
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 007987
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License Number State | NY
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