Healthcare Provider Details

I. General information

NPI: 1528609831
Provider Name (Legal Business Name): ANDREA CAROLINA SAENZ MS, RD, CDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2019
Last Update Date: 06/07/2025
Certification Date: 06/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 HENRY ST
NEW YORK NY
10002-5808
US

IV. Provider business mailing address

3441 78TH ST APT 6H
JACKSON HEIGHTS NY
11372-2535
US

V. Phone/Fax

Practice location:
  • Phone: 917-689-5808
  • Fax:
Mailing address:
  • Phone: 917-689-5808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number009814
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: