Provider Demographics
NPI:1881027332
Name:CHANTRY, CONSTANCE MARIE
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:MARIE
Last Name:CHANTRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CONSTANCE
Other - Middle Name:MARIE
Other - Last Name:SNODGRASS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:1304 BUCKLEY RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212-4311
Mailing Address - Country:US
Mailing Address - Phone:315-671-9950
Mailing Address - Fax:315-671-9960
Practice Address - Street 1:1304 BUCKLEY RD
Practice Address - Street 2:SUITE 200
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13212-4311
Practice Address - Country:US
Practice Address - Phone:315-671-9950
Practice Address - Fax:315-671-9960
Is Sole Proprietor?:No
Enumeration Date:2013-08-19
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal