Provider Demographics
NPI:1902415177
Name:CUADRA, TANIA MARIE (RDN)
Entity Type:Individual
Prefix:MS
First Name:TANIA
Middle Name:MARIE
Last Name:CUADRA
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 1:57 FINNERTY RD
Mailing Address - Street 2:
Mailing Address - City:WESTDALE
Mailing Address - State:NY
Mailing Address - Zip Code:13483-1300
Mailing Address - Country:US
Mailing Address - Phone:650-580-1126
Mailing Address - Fax:
Practice Address - Street 1:1 HOFFMAN ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-2157
Practice Address - Country:US
Practice Address - Phone:315-704-0319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-23
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86053342133V00000X
NY86053342133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered