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General NPI Number Information
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NPI Number | 1205039419
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Entity Type | Individual
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Provider Name | EVANGELIA KATSIGEORGIS RD, CDN
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Gender | Female
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 09/16/2020
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Provider Practice Location Address
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Address Line | 15730 9TH AVE
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City | WHITESTONE
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State | NY
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Zip | 11357-1318
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Country | US
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Telephone | 718-304-5080
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Fax |
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Provider Business Mailing Address
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Address Line | 15730 9TH AVE
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City | WHITESTONE
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State | NY
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Zip | 11357-1318
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Country | US
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Telephone | 718-304-5080
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 005177-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 005177
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License Number State | NY
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