Provider Demographics
NPI:1356638084
Name:MELOY, SARA E (RDN)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:E
Last Name:MELOY
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:E
Other - Last Name:MCILHENNY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 N 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 1:30 BALDWIN BLVD
Practice Address - Street 2:
Practice Address - City:SHAMOKIN DAM
Practice Address - State:PA
Practice Address - Zip Code:17876-9519
Practice Address - Country:US
Practice Address - Phone:570-884-7970
Practice Address - Fax:570-884-7975
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN004428133V00000X, 133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered