Provider Demographics
NPI:1568238822
Name:EVANS, CINDY DENISE (RDN, LDN)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:DENISE
Last Name:EVANS
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7157 161ST ST APT 2B
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-4497
Mailing Address - Country:US
Mailing Address - Phone:352-613-2622
Mailing Address - Fax:
Practice Address - Street 1:7157 161ST ST APT 2B
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11365-4497
Practice Address - Country:US
Practice Address - Phone:352-613-2622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered