Provider Demographics
NPI:1912220419
Name:LUTHER, DIANA M (RD, CDN)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:M
Last Name:LUTHER
Suffix:
Gender:F
Credentials:RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 566
Mailing Address - Street 2:
Mailing Address - City:LYONS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13368-0566
Mailing Address - Country:US
Mailing Address - Phone:315-486-3256
Mailing Address - Fax:
Practice Address - Street 1:4052 MARKHAM ST
Practice Address - Street 2:
Practice Address - City:LYONS FALLS
Practice Address - State:NY
Practice Address - Zip Code:13368-7409
Practice Address - Country:US
Practice Address - Phone:315-486-3256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY977930133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered