Provider Demographics
NPI:1275521858
Name:PINCKNEY, ANTONIA MARGHERITE (RD, RN)
Entity Type:Individual
Prefix:MS
First Name:ANTONIA
Middle Name:MARGHERITE
Last Name:PINCKNEY
Suffix:
Gender:F
Credentials:RD, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 CORRIGAN WAY
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519
Mailing Address - Country:US
Mailing Address - Phone:917-903-3867
Mailing Address - Fax:718-747-6690
Practice Address - Street 1:511 CORRIGAN WAY
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519
Practice Address - Country:US
Practice Address - Phone:917-903-3867
Practice Address - Fax:718-747-6690
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY618523-01163W00000X
NCL006018133V00000X
NY003897-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06344Medicare ID - Type UnspecifiedPROVIDER ID