Teresa Danyela Weis-Schupak, R.D., CDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

0005217 Issued in NY

Practice address

375 Broadway
Lawrence, NY 11559-1805

Phone

(516) 295-1186

NPI assigned

Mar 19, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205950698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 BROADWAY",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115591805",
            "telephone_number": "516-295-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 BROADWAY",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115591805",
            "telephone_number": "516-295-1186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIS-SCHUPAK",
        "first_name": "TERESA",
        "middle_name": "DANYELA",
        "name_prefix": "Mrs.",
        "credential": "R.D., CDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "0005217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Romeo Gerard Gerard Jr Perales Villavecncio
• Jennifer Watt, LPN
• Aliza Carolyn Weg, DDS
• Susan T. Weg, MA, CCC(SP)
• Mindy Weinstock
• Benjamin Z. Weiss, PHD.
• Shira Wender, FNP
• Alan Jonah Wieder, MD
• Shimshon Wiesel, DO
• Wilks Hearing Center Inc

• Registered Dietitian in Lawrence, NY
• Providers in Lawrence, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.