Provider Demographics
NPI:1598873721
Name:ATWELL, CINDY LEE (RD)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:LEE
Last Name:ATWELL
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 1:315 S MANNING BLVD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-1707
Mailing Address - Country:US
Mailing Address - Phone:518-525-1465
Mailing Address - Fax:518-525-6769
Practice Address - Street 1:315 S MANNING BLVD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-1707
Practice Address - Country:US
Practice Address - Phone:518-525-1465
Practice Address - Fax:518-525-6769
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2017-03-20
Deactivation Date:2011-07-22
Deactivation Code:
Reactivation Date:2015-02-10
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered