Provider Demographics
NPI:1700515913
Name:FARGNOLI, MERIDITH (RD)
Entity Type:Individual
Prefix:
First Name:MERIDITH
Middle Name:
Last Name:FARGNOLI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5091 STATE ROUTE 64 APT 1
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-9388
Mailing Address - Country:US
Mailing Address - Phone:443-800-2208
Mailing Address - Fax:
Practice Address - Street 1:5091 STATE ROUTE 64 APT 1
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-9388
Practice Address - Country:US
Practice Address - Phone:443-800-2208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered