Joanne Becker, CDN
Individual provider Active NPI Nutritionist · Scotia, NY
NPI 1629357751 · NPPES record last updated Mar 14, 2023
Key facts
- NPI
- 1629357751
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nutritionist 133N00000X
- License
- 48003974 (NY)
- Practice address
- 12 Kathleen Dr
Scotia, NY 12302-5708 - Phone
- (518) 384-1698
- NPI assigned
- Aug 7, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48003974 | NY | MD | Nutritionist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | 48003974 | NY | Yes |
Addresses
Primary practice location
12 Kathleen Dr
Scotia, NY 12302-5708
Mailing address
12 Kathleen Dr
Scotia, NY 12302-5708
Phone (518) 847-8879
Other providers in Scotia, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 14, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.