=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952493314
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KRISTEN CULLEN RD, CDN, CDE
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/29/2006
-----------------------------------------------------
Last Update Date | 03/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11 BARRETT HILL RD
-----------------------------------------------------
City | HOPEWELL JUNCTION
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12533-6953
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-418-0797
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11 BARRETT HILL RD
-----------------------------------------------------
City | HOPEWELL JUNCTION
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12533-6953
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-418-0797
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number | 00186301
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number | 812395
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------