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General NPI Number Information
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NPI Number | 1477688711
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Entity Type | Individual
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Provider Name | ANDREA CARNEVALE BLUTE MS RDN CDCES
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Gender | Female
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 10/03/2023
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Provider Practice Location Address
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Address Line | 223 NORTH VAN DIEN AVENUE
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City | RIDGEWOOD
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State | NJ
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Zip | 07450-2736
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Country | US
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Telephone | 201-634-5354
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Fax | 201-634-5385
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Provider Business Mailing Address
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Address Line | 223 N VAN DIEN AVE
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City | RIDGEWOOD
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State | NJ
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Zip | 07450-2736
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Country | US
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Telephone | 201-634-5371
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 724515
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License Number State |
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