Individual
MS. RANDI KONIKOFF BERANBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
5 WINGATE RD, PROVIDENCE, RI 02906-4909
(617) 470-0800
Mailing address
5 WINGATE RD, PROVIDENCE, RI 02906-4909
(617) 470-0800
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LDN00665
RI
Other
Enumeration date
10/26/2010
Last updated
10/26/2010
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