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General NPI Number Information
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NPI Number | 1821309642
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Entity Type | Individual
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Provider Name | CARLA A CORIATY-HULLA CDN
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Gender | Female
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Dates
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Enumeration Date | 06/25/2010
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 4300 HYLAN BLVD STE 2B
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City | STATEN ISLAND
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State | NY
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Zip | 10312-6505
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Country | US
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Telephone | 347-559-1254
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Fax | 347-695-2401
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Provider Business Mailing Address
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Address Line | 715 CRAIG AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10307-1511
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Country | US
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Telephone | 917-750-7786
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Fax | 347-695-2401
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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 | 0056461
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License Number State | NY
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