Active NPI
Vivian Sun, MS, RD, CDN
- Nutritionist
- Port Washington, NY
National Provider Identifier
1487410742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- 003855
- Practice address
- 67 Beacon Hill Rd
Port Washington, NY 11050-3035 - Phone
- (516) 888-7152
- NPI assigned
- Feb 26, 2024
- 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 |
|---|---|---|---|---|
| Nutritionist | 133N00000X | 003855 | NY | Primary |
Addresses
Primary practice location
67 Beacon Hill Rd
Port Washington, NY 11050-3035
Mailing address
67 Beacon Hill Rd
Port Washington, NY 11050-3035
Phone (516) 888-7152
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003855 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1708905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708905600000",
"number": "1487410742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "67 BEACON HILL RD",
"city": "PORT WASHINGTON",
"state": "NY",
"postal_code": "110503035",
"telephone_number": "516-888-7152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "67 BEACON HILL RD",
"city": "PORT WASHINGTON",
"state": "NY",
"postal_code": "110503035",
"telephone_number": "516-888-7152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUN",
"first_name": "VIVIAN",
"name_prefix": "Ms.",
"credential": "MS, RD, CDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-26",
"last_updated": "2024-02-26",
"certification_date": "2024-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "NY",
"license": "003855",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Washington, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.