Mildred Shedorick, R.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

001141-1 Issued in NY

Practice address

2412 Hudson St
East Meadow, NY 11554-5205

Phone

(516) 797-1366

NPI assigned

Sep 26, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Millie Shedorick Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210636800000",
    "number": "1518154251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2412 HUDSON ST",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115545205",
            "telephone_number": "516-797-1366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 HUDSON ST",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115545205",
            "telephone_number": "516-797-1366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEDORICK",
        "first_name": "MILDRED",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-26",
        "last_updated": "2008-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NY",
            "license": "001141-1",
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "NY",
            "license": "001141-1",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "001141-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MILLIE",
            "last_name": "SHEDORICK",
            "credential": "R.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Pratistha Sharma, MD
• Purna Sharma
• Sanvedna Sharma
• Smiley Sharma, DO
• Tiffany Shaw
• Stephanie Berger Sheffler, O.D.
• Moazam Sheikh, RPH
• Saher Sheikh
• Andrii Shevchuk
• Syed Tusneem Ahmed Shibli, MD

• Registered Dietitian in East Meadow, NY
• Providers in East Meadow, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.