Provider Demographics
NPI:1609132406
Name:STANFORD, MEREDITH (RD, CDN)
Entity type:Individual
Prefix:MRS
First Name:MEREDITH
Middle Name:
Last Name:STANFORD
Suffix:
Gender:F
Credentials:RD, CDN
Other - Prefix:MS
Other - First Name:MEREDITH
Other - Middle Name:
Other - Last Name:SOBEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, CDN
Mailing Address - Street 1:69 HILLCREST AVE
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-2304
Mailing Address - Country:US
Mailing Address - Phone:212-222-8187
Mailing Address - Fax:
Practice Address - Street 1:69 HILLCREST AVE
Practice Address - Street 2:
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-2304
Practice Address - Country:US
Practice Address - Phone:212-222-8187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-05
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered