Provider Demographics
NPI:1376555128
Name:SLINGERLAND, ALICE MAY (RD, CDN)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:MAY
Last Name:SLINGERLAND
Suffix:
Gender:F
Credentials:RD, CDN
Other - Prefix:
Other - First Name:ALICE
Other - Middle Name:WILSON
Other - Last Name:SLINGERLAND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD, CDN
Mailing Address - Street 1:1588 DELAWARE TPKE
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-5203
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:113 HOLLAND AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3410
Practice Address - Country:US
Practice Address - Phone:518-626-6872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001450-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered