Provider Demographics
NPI:1740548049
Name:CHINCOLA, CATHERINE A (RD,LDN,CDE)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:A
Last Name:CHINCOLA
Suffix:
Gender:
Credentials:RD,LDN,CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1025
Mailing Address - Street 2:
Mailing Address - City:BRODHEADSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18322-1025
Mailing Address - Country:US
Mailing Address - Phone:610-681-3300
Mailing Address - Fax:610-681-3343
Practice Address - Street 1:3065 ROUTE 50
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-2960
Practice Address - Country:US
Practice Address - Phone:518-886-5880
Practice Address - Fax:610-681-3343
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-25
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007732133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered