Provider Demographics
NPI:1992467138
Name:LUIBIL, CRISTINA ANN (MS, RD, LDN)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:ANN
Last Name:LUIBIL
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 W MAIN ST #636
Mailing Address - Street 2:
Mailing Address - City:NEW MARKET
Mailing Address - State:MD
Mailing Address - Zip Code:21774-0636
Mailing Address - Country:US
Mailing Address - Phone:908-783-5638
Mailing Address - Fax:
Practice Address - Street 1:6631 COMMODORE CT
Practice Address - Street 2:
Practice Address - City:NEW MARKET
Practice Address - State:MD
Practice Address - Zip Code:21774-6697
Practice Address - Country:US
Practice Address - Phone:908-783-5638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX4267133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered