Individual
MRS. DAWN RENEE COPPERTHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD,CDN
Contact information
Practice address
300 INTERNATIONAL DR, SUITE 100, WILLIAMSVILLE, NY 14221-5781
(716) 228-8163
(716) 626-3416
Mailing address
5666 KECK RD, LOCKPORT, NY 14094-9307
(716) 228-8163
(716) 626-3416
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
001213-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00026589601
UNIVERA HEALTHCARE #
NY
01
—
65-10942
INDEPENDENT HEALTH #
NY
01
—
J300238909
CMSMED
NY
Enumeration date
10/11/2006
Last updated
09/22/2015
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