Provider Demographics
NPI:1538290978
Name:THOMPSON DIPAOLO, SARAH A (MS, RD, CDN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:THOMPSON DIPAOLO
Suffix:
Gender:F
Credentials:MS, RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12835 WHITNEY RD
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14080-9753
Mailing Address - Country:US
Mailing Address - Phone:716-316-3722
Mailing Address - Fax:716-537-2475
Practice Address - Street 1:12835 WHITNEY RD
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:NY
Practice Address - Zip Code:14080-9753
Practice Address - Country:US
Practice Address - Phone:716-316-3722
Practice Address - Fax:716-537-2475
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0057541133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered