Individual
CHRISTINE MARY SERGENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CDN
Contact information
Practice address
243 PUGSLEY HILL RD, AMENIA, NY 12501-5008
(845) 206-1799
Mailing address
PO BOX 1314, MILLBROOK, NY 12545-1314
(845) 206-1799
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
726035
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001537-1
NYS DEPARTMENTOF EDUCATION LICENSE
NY
01
—
726035
ACADEMY OF NUTRITION AND DIETETICS MEMBER
NY
Enumeration date
08/06/2016
Last updated
08/06/2016
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