Provider Demographics
NPI:1508481581
Name:SIPANI, PRIYANKA (RDN)
Entity type:Individual
Prefix:
First Name:PRIYANKA
Middle Name:
Last Name:SIPANI
Suffix:
Gender:
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 FAHEY DR
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-7083
Mailing Address - Country:US
Mailing Address - Phone:802-999-9266
Mailing Address - Fax:
Practice Address - Street 1:109 STATE ST STE 5
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02109-2906
Practice Address - Country:US
Practice Address - Phone:617-505-1520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-15
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86148407133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered