Provider Demographics
NPI:1710141957
Name:TOMPKINS, LEA MARIE (MS, RD, CDN)
Entity Type:Individual
Prefix:MRS
First Name:LEA
Middle Name:MARIE
Last Name:TOMPKINS
Suffix:
Gender:F
Credentials:MS, RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BRODIE RD
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JCT
Mailing Address - State:NY
Mailing Address - Zip Code:12533-5424
Mailing Address - Country:US
Mailing Address - Phone:845-226-5851
Mailing Address - Fax:
Practice Address - Street 1:11 BRODIE RD
Practice Address - Street 2:
Practice Address - City:HOPEWELL JCT
Practice Address - State:NY
Practice Address - Zip Code:12533-5424
Practice Address - Country:US
Practice Address - Phone:845-226-5851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003525-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered