Healthcare Provider Details

I. General information

NPI: 1598513376
Provider Name (Legal Business Name): KRISTINA N CHIUSANO RD, CDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2024
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

247 PINEWOOD DR
SCHENECTADY NY
12303-5634
US

IV. Provider business mailing address

9202 TREMAY LN
SELKIRK NY
12158-1442
US

V. Phone/Fax

Practice location:
  • Phone: 845-670-3000
  • Fax:
Mailing address:
  • Phone: 845-670-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number011549
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: