Provider Demographics
NPI:1972680189
Name:BUXTON, CYNTHIA ANNE (MS RD LDN CDOE CLC)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ANNE
Last Name:BUXTON
Suffix:
Gender:F
Credentials:MS RD LDN CDOE CLC
Other - Prefix:MISS
Other - First Name:CYNTHIA
Other - Middle Name:ANNE
Other - Last Name:PRATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:49 OLD PINE RD
Mailing Address - Street 2:
Mailing Address - City:NARRAGANSETT
Mailing Address - State:RI
Mailing Address - Zip Code:02882-2406
Mailing Address - Country:US
Mailing Address - Phone:401-789-3744
Mailing Address - Fax:
Practice Address - Street 1:1 RIVER ST
Practice Address - Street 2:THUNDER MIST HEALTH CENTER OF SOUTH COUNTY
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879
Practice Address - Country:US
Practice Address - Phone:401-783-0523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILDN00157133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI292793OtherBLUE CROSS
RI28981OtherNEIGHBORHOOD HEALTH C
RI6300302OtherUNITED HEALTH CARE