Provider Demographics
NPI:1649589359
Name:PANEPINTO, JOAN MARIE (RN,RD,CDCES)
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:MARIE
Last Name:PANEPINTO
Suffix:
Gender:F
Credentials:RN,RD,CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 HARLEM RD RM 1520
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-4018
Mailing Address - Country:US
Mailing Address - Phone:716-891-2627
Mailing Address - Fax:716-862-1007
Practice Address - Street 1:2605 HARLEM RD RM 1520
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-4018
Practice Address - Country:US
Practice Address - Phone:716-891-2627
Practice Address - Fax:716-862-1007
Is Sole Proprietor?:No
Enumeration Date:2010-09-29
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006857133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered