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NPI Code Detail

MEDICARE: SARAH LYNN QUICK MS, RDN

MEDICARE: SARAH LYNN QUICK MS, RDN
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
1390200000XStudent in an Organized Health Care Education/Training ProgramNY
2133V00000XRegistered Dietitian010576NY

General Provider Information

NPI Number : 1669070413
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH LYNN QUICK MS, RDN
Provider Business Mailing Address
First Line : 104 FAIRWOOD DR
Second Line :
City : SYRACUSE
State : NY
Zip : 13219-2733
Country : US
Telephone Number : 315-401-0590
Fax Number :
Provider Business Practice Location Address
First Line : 5100 W GENESEE ST
Second Line :
City : CAMILLUS
State : NY
Zip : 13031-2354
Country : US
Telephone Number : 315-401-0590
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2020
Last Update Date : 08/27/2024

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