Provider Demographics
NPI:1467636241
Name:RUBINOFF-MYERS, CYNTHIA R (MS, RD, LD)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:R
Last Name:RUBINOFF-MYERS
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 GERRY AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-6103
Mailing Address - Country:US
Mailing Address - Phone:207-828-1618
Mailing Address - Fax:207-828-1618
Practice Address - Street 1:10 GERRY AVE
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-6103
Practice Address - Country:US
Practice Address - Phone:207-828-1618
Practice Address - Fax:207-828-1618
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MED1229133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic