Provider Demographics
NPI:1194537027
Name:CIRANNI, LYDIA (MS, RD)
Entity type:Individual
Prefix:MRS
First Name:LYDIA
Middle Name:
Last Name:CIRANNI
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:MISS
Other - First Name:LYDIA
Other - Middle Name:
Other - Last Name:CHAMPAGNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD
Mailing Address - Street 1:3108 GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:PIFFARD
Mailing Address - State:NY
Mailing Address - Zip Code:14533-9616
Mailing Address - Country:US
Mailing Address - Phone:585-645-8193
Mailing Address - Fax:
Practice Address - Street 1:919 WINTON RD S STE 220
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-1637
Practice Address - Country:US
Practice Address - Phone:585-204-0270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012344133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered