Healthcare Provider Details
I. General information
NPI: 1922083484
Provider Name (Legal Business Name): GRETCHEN A SCALPI R.D., CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/07/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
386 LIBERTY ST
BEACON NY
12508-2103
US
IV. Provider business mailing address
386 LIBERTY ST
BEACON NY
12508-2103
US
V. Phone/Fax
- Phone: 845-831-7258
- Fax: 845-831-5178
- Phone: 845-831-7258
- Fax: 845-831-5178
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | 001356-1 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: