Active NPI
Elicia McMullen, RD
- Registered Dietitian
- Albany, NY
National Provider Identifier
1225350150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 964241
- Practice address
- 43 New Scotland Ave
Albany, NY 12208-3412 - Phone
- (518) 262-4999
- Fax
- (518) 262-8374
- NPI assigned
- Feb 19, 2010
- 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 | 964241 | NY | Primary |
Addresses
Primary practice location
43 New Scotland Ave
Albany, NY 12208-3412
Mailing address
43 New Scotland Ave
Albany, NY 12208-3412
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 |
|---|---|---|---|
| 964241 | NY | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266537600000",
"number": "1225350150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43 NEW SCOTLAND AVE",
"city": "ALBANY",
"state": "NY",
"postal_code": "122083412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43 NEW SCOTLAND AVE",
"city": "ALBANY",
"state": "NY",
"postal_code": "122083412",
"telephone_number": "518-262-4999",
"fax_number": "518-262-8374"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMULLEN",
"first_name": "ELICIA",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-02-19",
"last_updated": "2010-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "964241",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albany, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.