Provider Demographics
NPI:1134947245
Name:PIATEK, MELINDA (RD, CDN)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:PIATEK
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 1:76 EAST RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-6861
Mailing Address - Country:US
Mailing Address - Phone:802-368-1385
Mailing Address - Fax:
Practice Address - Street 1:76 EAST RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-6861
Practice Address - Country:US
Practice Address - Phone:802-368-1385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1022225133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered