Provider Demographics
NPI:1891993283
Name:SINIBALDI, TRACEY K (RD, LDN, CDE)
Entity Type:Individual
Prefix:
First Name:TRACEY
Middle Name:K
Last Name:SINIBALDI
Suffix:
Gender:F
Credentials:RD, LDN, CDE
Other - Prefix:
Other - First Name:TRACEY
Other - Middle Name:K
Other - Last Name:SMEREKANICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:244 MANCHESTER WAY
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-2132
Mailing Address - Country:US
Mailing Address - Phone:302-897-2088
Mailing Address - Fax:302-376-9261
Practice Address - Street 1:244 MANCHESTER WAY
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-2132
Practice Address - Country:US
Practice Address - Phone:302-897-2088
Practice Address - Fax:302-376-9261
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEDN-0000209133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE00B690S31Medicare PIN