MEDICARE: CYNTHIA PHILBIN SAWICKY RD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	LDN00180	RI

General Provider Information

NPI Number	:	1518973957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA PHILBIN SAWICKY RD

Provider Business Mailing Address
First Line	:	1130 TEN ROD RD
Second Line	:	STE D101
City	:	NORTH KINGSTOWN
State	:	RI
Zip	:	02852-4161
Country	:	US
Telephone Number	:	401-667-0452
Fax Number	:	401-667-2894

Provider Business Practice Location Address
First Line	:	1130 TEN ROD RD
Second Line	:	STE D101
City	:	NORTH KINGSTOWN
State	:	RI
Zip	:	02852-4161
Country	:	US
Telephone Number	:	401-667-0452
Fax Number	:	401-667-2894

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	02/02/2018

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