Provider Demographics
NPI:1063007193
Name:CROSS, MEGHAN C (RDN, CSG)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:C
Last Name:CROSS
Suffix:
Gender:F
Credentials:RDN, CSG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1482 CHIGWELL LN N
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-9768
Mailing Address - Country:US
Mailing Address - Phone:585-269-8342
Mailing Address - Fax:
Practice Address - Street 1:1482 CHIGWELL LN N
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-9768
Practice Address - Country:US
Practice Address - Phone:585-269-8342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1101XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Gerontological