Healthcare Provider Details

I. General information

NPI: 1710316559
Provider Name (Legal Business Name): KATELYN CHOPY MS, RD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2013
Last Update Date: 11/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 EDDY ST HASBRO CHILDREN'S HOSPITAL ROOM 502
PROVIDENCE RI
02903-4923
US

IV. Provider business mailing address

593 EDDY ST HASBRO CHILDREN'S HOSPITAL ROOM 502
PROVIDENCE RI
02903-4923
US

V. Phone/Fax

Practice location:
  • Phone: 401-444-4847
  • Fax:
Mailing address:
  • Phone: 401-444-4847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License NumberLDN00760
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: