Provider Demographics
NPI:1720467384
Name:UMBRIANO, MEGAN (RD, LDN)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:UMBRIANO
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 CRANSTON ST UNIT 4
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-6700
Mailing Address - Country:US
Mailing Address - Phone:401-864-6212
Mailing Address - Fax:401-943-7938
Practice Address - Street 1:1320 CRANSTON ST UNIT 4
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-6700
Practice Address - Country:US
Practice Address - Phone:401-864-6212
Practice Address - Fax:401-943-7938
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-28
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILDN00762133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered