Provider Demographics
NPI:1487198909
Name:MILITANO, STEPHANIE (MS, RD, CSSD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:MILITANO
Suffix:
Gender:F
Credentials:MS, RD, CSSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 SKIMINO RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-2223
Mailing Address - Country:US
Mailing Address - Phone:757-585-4229
Mailing Address - Fax:
Practice Address - Street 1:154 SKIMINO RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-2223
Practice Address - Country:US
Practice Address - Phone:757-585-4229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-19
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered