Provider Demographics
NPI:1356053839
Name:SERAFINE, TONILYNN (RDN)
Entity type:Individual
Prefix:
First Name:TONILYNN
Middle Name:
Last Name:SERAFINE
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 1:155 BUCK RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DRUMS
Mailing Address - State:PA
Mailing Address - Zip Code:18222-1014
Mailing Address - Country:US
Mailing Address - Phone:570-578-4365
Mailing Address - Fax:
Practice Address - Street 1:155 BUCK RIDGE DR
Practice Address - Street 2:
Practice Address - City:DRUMS
Practice Address - State:PA
Practice Address - Zip Code:18222-1014
Practice Address - Country:US
Practice Address - Phone:570-578-4365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-15
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered