Provider Demographics
NPI:1710598800
Name:SHAMLIAN, CATHERINE (RDN)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:SHAMLIAN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4240 LAFAYETTE RD
Mailing Address - Street 2:
Mailing Address - City:JAMESVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13078-9770
Mailing Address - Country:US
Mailing Address - Phone:315-430-5593
Mailing Address - Fax:
Practice Address - Street 1:4240 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:JAMESVILLE
Practice Address - State:NY
Practice Address - Zip Code:13078-9770
Practice Address - Country:US
Practice Address - Phone:315-430-5593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-12
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered