Healthcare Provider Details

I. General information

NPI: 1649144908
Provider Name (Legal Business Name): KRISTYNA ZAPPASODI
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2025
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 RACHEL TER APT 23
PINE BROOK NJ
07058-9341
US

IV. Provider business mailing address

2400 RACHEL TER APT 23
PINE BROOK NJ
07058-9341
US

V. Phone/Fax

Practice location:
  • Phone: 631-974-2787
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86131231
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: