Individual provider Active NPI

Marina Bedrossian, RDN, CDN

  • Registered Dietitian
  • Huntington, NY
National Provider Identifier
1366727687
Registry record updated Jan 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1066034 Issued in NY
Practice address
77 N Woodhull Rd
Huntington, NY 11743-2826
Phone
(631) 374-6371
Fax
(631) 498-1174
NPI assigned
Oct 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2017

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 1066034 NY Primary

Addresses

Primary practice location

77 N Woodhull Rd
Huntington, NY 11743-2826

Mailing address

77 N Woodhull Rd
Huntington, NY 11743-2826
Phone (631) 374-6371

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
1066034NYMDRegistered Dietitian
007284NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Ingredients for Health, PLLC Dietitian, Registered Past Accepting new patients
Marina Stauffer, Registered Dietitian, Certified Dietitian Nutritionis Dietitian, Registered Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1318896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483574400000",
    "number": "1366727687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 N WOODHULL RD",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432826",
            "telephone_number": "631-374-6371",
            "fax_number": "631-498-1174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 N WOODHULL RD",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432826",
            "telephone_number": "631-374-6371",
            "fax_number": "631-498-1174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDROSSIAN",
        "first_name": "MARINA",
        "credential": "RDN, CDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-18",
        "last_updated": "2017-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "1066034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; 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.