Provider Demographics
NPI:1104051648
Name:HART, ANDREA FOIT (RD, CDN)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:FOIT
Last Name:HART
Suffix:
Gender:F
Credentials:RD, CDN
Other - Prefix:MISS
Other - First Name:ANDREA
Other - Middle Name:BARBARA
Other - Last Name:FOIT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:701 LENOX AVE
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:NY
Mailing Address - Zip Code:13421-1500
Mailing Address - Country:US
Mailing Address - Phone:315-363-9281
Mailing Address - Fax:315-363-9286
Practice Address - Street 1:823 ROUTE 13
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-8835
Practice Address - Country:US
Practice Address - Phone:607-758-8850
Practice Address - Fax:607-218-0201
Is Sole Proprietor?:No
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005146133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04800005146Medicaid