Provider Demographics
NPI:1003995036
Name:CLIFFORD-CARTWRIGHT, AMY (RD, LDN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:CLIFFORD-CARTWRIGHT
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:CARTWRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN
Mailing Address - Street 1:100 NORTH ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:1800 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-6800
Practice Address - Country:US
Practice Address - Phone:570-703-8084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN000747133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1793547OtherHIGHMARK BLUE SHIELD FEP
PA820520OtherFIRST PRIORITY HEALTH
PA7764754OtherAETNA