Provider Demographics
NPI:1609376748
Name:TINARI, SHAYLYN (MS, RD, LDN)
Entity Type:Individual
Prefix:
First Name:SHAYLYN
Middle Name:
Last Name:TINARI
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-3912
Mailing Address - Country:US
Mailing Address - Phone:267-585-4247
Mailing Address - Fax:484-470-1177
Practice Address - Street 1:945 CHURCH RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-3912
Practice Address - Country:US
Practice Address - Phone:267-585-4247
Practice Address - Fax:484-470-1177
Is Sole Proprietor?:No
Enumeration Date:2018-02-15
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN006048133N00000X
133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist