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General NPI Number Information
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NPI Number | 1750221438
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Entity Type | Individual
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Provider Name | KONSTANTINA SOPHIA STAURULAKIS RDN
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Gender | Female
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Dates
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Enumeration Date | 03/31/2026
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Last Update Date | 03/31/2026
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Provider Practice Location Address
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Address Line | 183 GRAND ST APT 2
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City | NEW YORK
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State | NY
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Zip | 10013-3734
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Country | US
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Telephone | 703-609-5535
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Fax |
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Provider Business Mailing Address
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Address Line | 7306 PETER PL
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City | MC LEAN
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State | VA
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Zip | 22102-2153
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Country | US
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Telephone |
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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 |
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License Number State |
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