Healthcare Provider Details

I. General information

NPI: 1639016488
Provider Name (Legal Business Name): EVA ROONEY RDN, CDN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 EVERGREEN AVE
RYE NY
10580-2052
US

IV. Provider business mailing address

95 EVERGREEN AVE
RYE NY
10580-2052
US

V. Phone/Fax

Practice location:
  • Phone: 314-550-8999
  • Fax:
Mailing address:
  • Phone: 314-550-8999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number007914-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: