Individual provider Active NPI

Sandra J Arevalo, MPH, RD, CDE

  • Registered Dietitian
  • Bronx, NY
National Provider Identifier
1306199468
Registry record updated Oct 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
871 Prospect Ave
Bronx, NY 10459-3913
Phone
(718) 991-0605
Fax
(718) 991-2931
NPI assigned
Oct 25, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

871 Prospect Ave
Bronx, NY 10459-3913

Mailing address

871 Prospect Ave
Bronx, NY 10459-3913

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
006591NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351123200000",
    "number": "1306199468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "871 PROSPECT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104593913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "871 PROSPECT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104593913",
            "telephone_number": "718-991-0605",
            "fax_number": "718-991-2931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AREVALO",
        "first_name": "SANDRA",
        "middle_name": "J",
        "credential": "MPH, RD, CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-25",
        "last_updated": "2012-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; 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.