Provider Demographics
NPI:1154616365
Name:DEL CORO, KRISTY (MS, RDN)
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:
Last Name:DEL CORO
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 WALNUT HILL RD
Mailing Address - Street 2:
Mailing Address - City:NORTH YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04097-6507
Mailing Address - Country:US
Mailing Address - Phone:410-430-0730
Mailing Address - Fax:
Practice Address - Street 1:165 WALNUT HILL RD
Practice Address - Street 2:
Practice Address - City:NORTH YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04097-6507
Practice Address - Country:US
Practice Address - Phone:410-430-0730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-15
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY48 006579133N00000X
00978064133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist