Healthcare Provider Details

I. General information

NPI: 1922770510
Provider Name (Legal Business Name): STEVEN F BIAMONTE RD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2021
Last Update Date: 10/01/2021
Certification Date: 10/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 WASHINGTON AVE
SOUND BEACH NY
11789-2551
US

IV. Provider business mailing address

19 WASHINGTON AVE
SOUND BEACH NY
11789-2551
US

V. Phone/Fax

Practice location:
  • Phone: 631-576-7204
  • Fax:
Mailing address:
  • Phone: 631-576-7204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number86093624
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number86093624
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number86093624
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number86093624
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code133VN1501X
TaxonomySports Dietetics Nutrition Registered Dietitian
License Number86093624
License Number StateNY
# 6
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86093624
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: