Provider Demographics
NPI:1700617024
Name:FARIAS, MARIA (RD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:FARIAS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 ROWE RD
Mailing Address - Street 2:
Mailing Address - City:RED HOOK
Mailing Address - State:NY
Mailing Address - Zip Code:12571-4745
Mailing Address - Country:US
Mailing Address - Phone:845-514-7440
Mailing Address - Fax:
Practice Address - Street 1:59 ROWE RD
Practice Address - Street 2:
Practice Address - City:RED HOOK
Practice Address - State:NY
Practice Address - Zip Code:12571-4745
Practice Address - Country:US
Practice Address - Phone:845-514-7440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered