Provider Demographics
NPI:1609458900
Name:ROCHE-KINDELAN, MAURA ANN (RD, CDN)
Entity Type:Individual
Prefix:MRS
First Name:MAURA
Middle Name:ANN
Last Name:ROCHE-KINDELAN
Suffix:
Gender:F
Credentials:RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 AVONDALE RD
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-2069
Mailing Address - Country:US
Mailing Address - Phone:914-589-2635
Mailing Address - Fax:
Practice Address - Street 1:80 AVONDALE RD
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-2069
Practice Address - Country:US
Practice Address - Phone:914-589-2635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered