Provider Demographics
NPI:1467231845
Name:LOGLIO, FELICIA (RD, CDN)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:LOGLIO
Suffix:
Gender:F
Credentials:RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 BRONK LAKE RD
Mailing Address - Street 2:
Mailing Address - City:COXSACKIE
Mailing Address - State:NY
Mailing Address - Zip Code:12051-1802
Mailing Address - Country:US
Mailing Address - Phone:518-610-1822
Mailing Address - Fax:
Practice Address - Street 1:614 BRONK LAKE RD
Practice Address - Street 2:
Practice Address - City:COXSACKIE
Practice Address - State:NY
Practice Address - Zip Code:12051-1802
Practice Address - Country:US
Practice Address - Phone:518-610-1822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009809-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered