Individual provider Active NPI

Sandra Ann Degennaro, R.D.

  • Registered Dietitian
  • Buffalo, NY
National Provider Identifier
1740433150
Registry record updated Oct 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
00995988 Issued in NY
Practice address
3495 Bailey Ave
Nutrition Department
Buffalo, NY 14215-1129
Phone
(716) 834-9200
Fax
(716) 862-6374
NPI assigned
Oct 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 00995988 NY Primary

Addresses

Primary practice location

3495 Bailey Ave
Nutrition Department
Buffalo, NY 14215-1129

Mailing address

3495 Bailey Ave
Nutrition Department
Buffalo, NY 14215-1129
Phone (716) 834-9200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
00995988NYMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1225238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225238400000",
    "number": "1740433150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 BAILEY AVE",
            "address_2": "NUTRITION DEPARTMENT",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142151129",
            "telephone_number": "716-834-9200",
            "fax_number": "716-862-6374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3495 BAILEY AVE",
            "address_2": "NUTRITION DEPARTMENT",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142151129",
            "telephone_number": "716-834-9200",
            "fax_number": "716-862-6374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGENNARO",
        "first_name": "SANDRA",
        "middle_name": "ANN",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-29",
        "last_updated": "2008-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "00995988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.