Provider Demographics
NPI:1316796014
Name:MASON, AIMEE MARIE (MS, RDN, LDN, CDN)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:MARIE
Last Name:MASON
Suffix:
Gender:F
Credentials:MS, RDN, LDN, CDN
Other - Prefix:
Other - First Name:AIMEE
Other - Middle Name:
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1927 UPPER BIRCH RUN RD
Mailing Address - Street 2:
Mailing Address - City:ALLEGANY
Mailing Address - State:NY
Mailing Address - Zip Code:14706-9514
Mailing Address - Country:US
Mailing Address - Phone:716-378-4191
Mailing Address - Fax:
Practice Address - Street 1:1927 UPPER BIRCH RUN RD
Practice Address - Street 2:
Practice Address - City:ALLEGANY
Practice Address - State:NY
Practice Address - Zip Code:14706-9514
Practice Address - Country:US
Practice Address - Phone:716-378-4191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX2497133V00000X
PADN003384133V00000X
NY011979133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered