Provider Demographics
NPI:1750701686
Name:MIOR, CHRISTINA (RD, CDN)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:MIOR
Suffix:
Gender:F
Credentials:RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:739 UNIVERSITY AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-1225
Mailing Address - Country:US
Mailing Address - Phone:315-882-6468
Mailing Address - Fax:
Practice Address - Street 1:1415 PORTLAND AVE STE 225
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-3039
Practice Address - Country:US
Practice Address - Phone:585-922-2900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-17
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007953133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered