Organization Active NPI

Marina Stauffer, Registered Dietitian, Certified Dietitian Nutritionis

  • Registered Dietitian
  • Northport, NY
National Provider Identifier
1467797100
Registry record updated Jan 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
007284-1 Issued in NY
Legal business name
MARINA STAUFFER, REGISTERED DIETITIAN, CERTIFIED DIETITIAN NUTRITIONIS
Practice address
694 Fort Salonga Rd
Northport, NY 11768-3147
Phone
(631) 374-6371
NPI assigned
Dec 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2013

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

Authorized official

Name
Marina Stauffer, RD, CDN
Title
Owner
Phone
(631) 374-6371

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X 007284-1 NY Primary

Addresses

Primary practice location

694 Fort Salonga Rd
Northport, NY 11768-3147

Mailing address

44 Cherry LN
Huntington, NY 11743-2945
Phone (631) 374-6371

Other names 1

  • Marina Stauffer, RD, CDN, PLLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ingredients for Health PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

694 Fort Salonga Rd
Northport, NY 11768
Phone (631) 374-6371

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1354752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359331200000",
    "number": "1467797100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 CHERRY LN",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432945",
            "telephone_number": "631-374-6371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "694 FORT SALONGA RD",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117683147",
            "telephone_number": "631-374-6371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARINA STAUFFER, REGISTERED DIETITIAN, CERTIFIED DIETITIAN NUTRITIONIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-06",
        "last_updated": "2013-01-28",
        "status": "A",
        "authorized_official_last_name": "STAUFFER",
        "authorized_official_first_name": "MARINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-374-6371",
        "authorized_official_credential": "RD, CDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "007284-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marina Stauffer, RD, CDN, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Northport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; 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.