Provider Demographics
NPI:1750043212
Name:EREIO, SARAH ANNE (RD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANNE
Last Name:EREIO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ANNE
Other - Last Name:HINES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:30 WHIPPLE WAY
Mailing Address - Street 2:
Mailing Address - City:ALTAMONT
Mailing Address - State:NY
Mailing Address - Zip Code:12009-9203
Mailing Address - Country:US
Mailing Address - Phone:518-424-2490
Mailing Address - Fax:
Practice Address - Street 1:178 GRANDVIEW DR
Practice Address - Street 2:
Practice Address - City:COBLESKILL
Practice Address - State:NY
Practice Address - Zip Code:12043-5144
Practice Address - Country:US
Practice Address - Phone:518-254-3441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009687133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered