Healthcare Provider Details

I. General information

NPI: 1225878010
Provider Name (Legal Business Name): CATHERINE ZUCCARELLO RDN, CDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2024
Last Update Date: 05/29/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 W 15TH ST
NEW YORK NY
10011-5903
US

IV. Provider business mailing address

325 W 15TH ST
NEW YORK NY
10011-5903
US

V. Phone/Fax

Practice location:
  • Phone: 212-367-1891
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1301X
TaxonomyOncology Nutrition Registered Dietitian
License Number86151250
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: