Provider Demographics
NPI:1528423803
Name:MCCOY, ANNABELLE (RD,CDE,LDN)
Entity type:Individual
Prefix:
First Name:ANNABELLE
Middle Name:
Last Name:MCCOY
Suffix:
Gender:F
Credentials:RD,CDE,LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3824 NORTHERN PIKE STE 415
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2162
Mailing Address - Country:US
Mailing Address - Phone:412-342-6030
Mailing Address - Fax:
Practice Address - Street 1:3824 NORTHERN PIKE STE 415
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2162
Practice Address - Country:US
Practice Address - Phone:412-342-6030
Practice Address - Fax:412-457-0410
Is Sole Proprietor?:No
Enumeration Date:2015-12-30
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN000407133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic