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General NPI Number Information
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NPI Number | 1821113044
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Entity Type | Individual
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Provider Name | LYNN MARIE MALONEY CDN
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Gender | Female
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5259 PARKSIDE DR
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City | CANANDAIGUA
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State | NY
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Zip | 14424
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Country | US
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Telephone | 585-394-7140
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Fax | 585-394-9405
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Provider Business Mailing Address
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Address Line | 8279 MCCLURG RD
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City | HONEOYE
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State | NY
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Zip | 14471
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Country | US
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Telephone | 585-229-4302
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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 | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 0040221
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License Number State | NY
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