Provider Demographics
NPI:1245888650
Name:PARIS, ANTHONY WAYNE JR (RD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:WAYNE
Last Name:PARIS
Suffix:JR
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 ROUND HILL RD
Mailing Address - Street 2:
Mailing Address - City:FOSTER
Mailing Address - State:RI
Mailing Address - Zip Code:02825-1447
Mailing Address - Country:US
Mailing Address - Phone:401-649-7941
Mailing Address - Fax:
Practice Address - Street 1:1370 CRANSTON ST
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-6758
Practice Address - Country:US
Practice Address - Phone:401-943-4142
Practice Address - Fax:401-943-4151
Is Sole Proprietor?:No
Enumeration Date:2019-08-28
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered