Active NPI
Tara Abba, MS, RD, CNSC
- Registered Dietitian
- Delmar, NY
National Provider Identifier
1629761853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 009484
- Practice address
- 125 Adams St
Delmar, NY 12054-3211 - Phone
- (518) 470-0866
- Fax
- (518) 380-6266
- NPI assigned
- Jun 1, 2023
- Last updated
- Jun 1, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 009484 | NY | Primary |
Addresses
Primary practice location
125 Adams St
Delmar, NY 12054-3211
Mailing address
2481 Eastern Pkwy
Niskayuna, NY 12309-6307
Phone (719) 306-2426
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230808000089 | NY | Practitioner - Registered Dietitian Or Nutrition Professional | 0840651824 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009484 | NY | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685577600000",
"number": "1629761853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2481 EASTERN PKWY",
"city": "NISKAYUNA",
"state": "NY",
"postal_code": "123096307",
"telephone_number": "719-306-2426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 ADAMS ST",
"city": "DELMAR",
"state": "NY",
"postal_code": "120543211",
"telephone_number": "518-470-0866",
"fax_number": "518-380-6266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABBA",
"first_name": "TARA",
"credential": "MS, RD, CNSC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-01",
"last_updated": "2023-06-01",
"certification_date": "2023-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "009484",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Delmar, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.