Individual provider Active NPI

Angela Simona Carullo, RD,CDN

  • Registered Dietitian
  • New York, NY
National Provider Identifier
1568016343
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86042924 Issued in NY
Practice address
41 Madison Ave FL 25
New York, NY 10010-2212
Phone
(917) 577-6384
NPI assigned
Jul 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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 86042924 NY Primary

Addresses

Primary practice location

41 Madison Ave FL 25
New York, NY 10010-2212

Mailing address

41 Madison Ave
New York, NY 10010-2202

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

LicenseStateTypeSpecialty
86042924NYMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1564444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1568016343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100102202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 MADISON AVE FL 25",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100102212",
            "telephone_number": "917-577-6384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARULLO",
        "first_name": "ANGELA",
        "middle_name": "SIMONA",
        "credential": "RD,CDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-30",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "86042924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; 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.