Racquel Praino, MS, RD

Individual provider Active NPI Registered Dietitian · Port Ewen, NY

NPI 1194577205 · NPPES record last updated Apr 2, 2024

Key facts

NPI
1194577205
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
86066091
Practice address
186 Broadway
Port Ewen, NY 12466-7707
Phone
(914) 299-5959
NPI assigned
Apr 2, 2024
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

44 Holland Ave
Albany, NY 12208-3411

76 Firemens Way
Poughkeepsie, NY 12603-6519

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20260331004133 NY Practitioner - Registered Dietitian Or Nutrition Professional 7113402751 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Science

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86066091 Yes

Addresses

Primary practice location

186 Broadway
Port Ewen, NY 12466-7707

Mailing address

186 Broadway
Port Ewen, NY 12466-7707
Phone (914) 299-5959

Other identifiers

IdentifierTypeStateIssuer
86066091OtherCOMMISSION ON DIETETIC REGISTRATION
0074688OtherNYNEW YORK EDUCATION DEPARTMENT OFFICE OF THE PROFESSIONS

Other providers in Port Ewen, NY

All providers in Port Ewen, NY · Registered Dietitian in New York

Sources for this page

Verify at the official NPI Registry.