Provider Demographics
NPI:1649569294
Name:PERRY, ROBYNLEE RILEY (RD)
Entity Type:Individual
Prefix:MRS
First Name:ROBYNLEE
Middle Name:RILEY
Last Name:PERRY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:ROBYN
Other - Middle Name:LEE
Other - Last Name:RILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:95 MEADOWLAND DR
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-3105
Mailing Address - Country:US
Mailing Address - Phone:401-295-7849
Mailing Address - Fax:
Practice Address - Street 1:95 MEADOWLAND DR
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-3105
Practice Address - Country:US
Practice Address - Phone:401-295-7849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILDN00483133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered