Active NPI
Christina Mandolfo, RDN
- Registered Dietitian
- Orchard Park, NY
National Provider Identifier
1043783400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 009656
- Practice address
- 3685 Southwestern Blvd
Orchard Park, NY 14127-1732 - Phone
- (716) 557-7227
- NPI assigned
- Jan 9, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 009656 | NY | Primary |
Addresses
Primary practice location
3685 Southwestern Blvd
Orchard Park, NY 14127-1732
Mailing address
826 Auburn Ave
Buffalo, NY 14222-1419
Phone (716) 884-4506
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009656 | NY | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546992000000",
"number": "1043783400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "826 AUBURN AVE",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142221419",
"telephone_number": "716-884-4506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3685 SOUTHWESTERN BLVD",
"city": "ORCHARD PARK",
"state": "NY",
"postal_code": "141271732",
"telephone_number": "716-557-7227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDOLFO",
"first_name": "CHRISTINA",
"credential": "RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-09",
"last_updated": "2019-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "009656",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Orchard Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.