Provider Demographics
NPI:1023304516
Name:FIUMANO, JUDYANN (MS, RD, RN)
Entity type:Individual
Prefix:MISS
First Name:JUDYANN
Middle Name:
Last Name:FIUMANO
Suffix:
Gender:F
Credentials:MS, RD, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 KILLINGTON RD
Mailing Address - Street 2:APARTMENT 6
Mailing Address - City:KILLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05751-9700
Mailing Address - Country:US
Mailing Address - Phone:917-676-6857
Mailing Address - Fax:
Practice Address - Street 1:2910 KILLINGTON RD
Practice Address - Street 2:APARTMENT 6
Practice Address - City:KILLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05751-9700
Practice Address - Country:US
Practice Address - Phone:917-676-6857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0740075665133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1019072Medicaid