Provider Demographics
NPI:1972971539
Name:SHERRY, AMELIA RYAN (RD)
Entity type:Individual
Prefix:MRS
First Name:AMELIA
Middle Name:RYAN
Last Name:SHERRY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10706-1404
Mailing Address - Country:US
Mailing Address - Phone:914-572-5867
Mailing Address - Fax:
Practice Address - Street 1:40 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:HASTINGS ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10706-1404
Practice Address - Country:US
Practice Address - Phone:914-572-5867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-11
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered