Healthcare Provider Details
I. General information
NPI: 1982767539
Provider Name (Legal Business Name): CATHERINE M CAREY RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/18/2006
Last Update Date: 04/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
402 POTTER BLVD
BRIGHTWATERS NY
11718-1830
US
IV. Provider business mailing address
402 POTTER BLVD
BRIGHTWATERS NY
11718-1830
US
V. Phone/Fax
- Phone: 631-587-1800
- Fax:
- Phone: 631-587-1800
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: