Provider Demographics
NPI:1851362248
Name:WOODMAN, CYNTHIA MILNER (MS, RDN, LDN)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:MILNER
Last Name:WOODMAN
Suffix:
Gender:F
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 MORSE CIR
Mailing Address - Street 2:
Mailing Address - City:SHIRLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01464-2908
Mailing Address - Country:US
Mailing Address - Phone:978-425-5785
Mailing Address - Fax:978-425-5783
Practice Address - Street 1:16 MORSE CIR
Practice Address - Street 2:
Practice Address - City:SHIRLEY
Practice Address - State:MA
Practice Address - Zip Code:01464-2908
Practice Address - Country:US
Practice Address - Phone:978-425-5785
Practice Address - Fax:978-425-5783
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MANU772133V00000X, 133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA31143Medicare UPIN
MAMT0506Medicare ID - Type UnspecifiedREGISTERED DIETITIAN