Provider Demographics
NPI:1568639813
Name:VERDI, MELISSA ANNE (MS, RDN, CDN, CDCES)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ANNE
Last Name:VERDI
Suffix:
Gender:F
Credentials:MS, RDN, CDN, CDCES
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:ANNE
Other - Last Name:WALDORF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, CDN
Mailing Address - Street 1:17 KELLY ANN DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:NY
Mailing Address - Zip Code:14086-1413
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9097 MAIN ST
Practice Address - Street 2:
Practice Address - City:CLARENCE
Practice Address - State:NY
Practice Address - Zip Code:14031-1965
Practice Address - Country:US
Practice Address - Phone:716-222-0297
Practice Address - Fax:716-794-9466
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0064931133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty