Provider Demographics
NPI:1639060684
Name:SAGATCHI, SINA B (MS, RDN, LDN)
Entity type:Individual
Prefix:
First Name:SINA
Middle Name:B
Last Name:SAGATCHI
Suffix:
Gender:M
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 LORRAINE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28270-0905
Mailing Address - Country:US
Mailing Address - Phone:980-219-0173
Mailing Address - Fax:
Practice Address - Street 1:8600 LORRAINE DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28270-0905
Practice Address - Country:US
Practice Address - Phone:980-219-0173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL004766133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist