Provider Demographics
NPI:1467829077
Name:CINQUINO, MICHELE (RD)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:CINQUINO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:461 JOHN JAMES AUDUBON PKWY
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-1141
Mailing Address - Country:US
Mailing Address - Phone:716-810-1843
Mailing Address - Fax:716-250-3160
Practice Address - Street 1:461 JOHN JAMES AUDUBON PKWY
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-1141
Practice Address - Country:US
Practice Address - Phone:716-810-1843
Practice Address - Fax:716-250-3160
Is Sole Proprietor?:No
Enumeration Date:2015-08-31
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006714-1133N00000X
NY894227133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist