Provider Demographics
NPI:1467572099
Name:FERRARA, LINDSAY M (MS, RD)
Entity Type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:M
Last Name:FERRARA
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:M
Other - Last Name:SAWYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:108 WALNUT DR
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-7300
Mailing Address - Country:US
Mailing Address - Phone:518-796-3042
Mailing Address - Fax:
Practice Address - Street 1:1 COBBLE HILL DR
Practice Address - Street 2:
Practice Address - City:GANSEVOORT
Practice Address - State:NY
Practice Address - Zip Code:12831-2524
Practice Address - Country:US
Practice Address - Phone:518-796-3042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005690-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA0842Medicare ID - Type Unspecified