Provider Demographics
NPI:1316692130
Name:MCNEAR, STEPHANIE (MS, RDN, CDN)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:MCNEAR
Suffix:
Gender:F
Credentials:MS, RDN, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 GLENWOOD ST APT 7
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-2825
Mailing Address - Country:US
Mailing Address - Phone:415-603-8028
Mailing Address - Fax:
Practice Address - Street 1:34 GLENWOOD ST APT 7
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-2825
Practice Address - Country:US
Practice Address - Phone:415-603-8028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-21
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered