Provider Demographics
NPI:1629690078
Name:BINTZ, LAUREN (RD, CDN)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:BINTZ
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 1:18 FEATHERS DR
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-6461
Mailing Address - Country:US
Mailing Address - Phone:518-324-2040
Mailing Address - Fax:
Practice Address - Street 1:18 FEATHERS DR
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-6461
Practice Address - Country:US
Practice Address - Phone:518-324-2040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-08
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010136133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric