Provider Demographics
NPI:1972185981
Name:WINKWORTH, MARIA C (RDN)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:C
Last Name:WINKWORTH
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 PLUM ST APT 402
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204-1525
Mailing Address - Country:US
Mailing Address - Phone:315-412-9491
Mailing Address - Fax:
Practice Address - Street 1:525 PLUM ST APT 402
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13204-1525
Practice Address - Country:US
Practice Address - Phone:315-412-9491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered