Active NPI
Carolyn E Antoniw, MSRDN
- Registered Dietitian
- Montour Falls, NY
National Provider Identifier
1053781377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 006214-1
- Practice address
- 220 Steuben Street
Montour Falls, NY 14865 - Phone
- (607) 535-7121
- NPI assigned
- Sep 29, 2015
- Sex
- Female
- Sole proprietor
- No
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 | 006214-1 | NY | Primary |
Addresses
Primary practice location
220 Steuben Street
Montour Falls, NY 14865
Mailing address
220 Steuben Street
Montour Falls, NY 14865
Phone (607) 535-7121
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 |
|---|---|---|---|
| 006214-1 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443484800000",
"number": "1053781377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 STEUBEN STREET",
"city": "MONTOUR FALLS",
"state": "NY",
"postal_code": "14865",
"telephone_number": "607-535-7121",
"fax_number": "607-210-1936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 STEUBEN STREET",
"city": "MONTOUR FALLS",
"state": "NY",
"postal_code": "14865",
"telephone_number": "607-535-7121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTONIW",
"first_name": "CAROLYN",
"middle_name": "E",
"name_prefix": "Ms.",
"credential": "MSRDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-29",
"last_updated": "2015-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "006214-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montour Falls, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.