National Provider Identifier
Richard Edward Packard Jr., RDN, LDN, MBA, CDCES
Richard Edward Packard Jr., RDN, LDN, MBA, CDCES is listed in the NPPES registry with a primary specialty of Registered Dietitian in Horseheads, NY and a listed phone number of (607) 317-7177.
Profile Overview
- NPI
- 1821372376
- Provider Type
- Individual
- Primary Specialty
- Registered Dietitian
- Enumeration Date
- October 03, 2011
- Last Updated
- November 08, 2024
Practice Location
- 200 Meadow Dr
- Horseheads, NY 14845-1716
Phone: (607) 317-7177
Specialties
- Registered Dietitian (133V00000X)
- Registered Dietitian (133V00000X)
Full Record
- NPI
- 1821372376
- Entity Type
- Individual
- Last Name
- Packard
- First Name
- Richard
- Middle Name
- Edward
- Name Prefix
- Mr.
- Name Suffix
- Jr.
- Credential
- RDN, LDN, MBA, CDCES
- Mailing Street Address
- 200 Meadow Dr
- Mailing City
- Horseheads
- Mailing State
- NY
- Mailing ZIP Code
- 14845-1716
- Mailing Country
- US
- Mailing Phone
- (607) 317-7177
- Mailing Fax
- (607) 302-4106
- Practice Street Address
- 200 Meadow Dr
- Practice City
- Horseheads
- Practice State
- NY
- Practice ZIP Code
- 14845-1716
- Practice Country
- US
- Practice Phone
- (607) 317-7177
- Practice Fax
- (607) 302-4106
- Enumeration Date
- October 03, 2011
- Last Updated
- November 08, 2024
- Sex
- Male
- Sole Proprietor
- Yes
- Certification Date
- November 08, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Registered Dietitian (133V00000X), Registered Dietitian (133V00000X)