Evelyn Fuller, RDN, CDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

010110 Issued in NY

Practice address

81 W Bayard St
Seneca Falls, NY 13148-1807

Phone

(904) 239-0077

NPI assigned

Aug 17, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1639780232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 GREEN ST",
            "city": "SENECA FALLS",
            "state": "NY",
            "postal_code": "131482026",
            "telephone_number": "904-239-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 W BAYARD ST",
            "city": "SENECA FALLS",
            "state": "NY",
            "postal_code": "131481807",
            "telephone_number": "904-239-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "EVELYN",
        "credential": "RDN, CDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-17",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "010110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Finger Lakes Evaluation Group
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• Nathaniel Fisher, D.C.
• FLH Medical, PC
• Grace Maria Freier, MD
• Lisa Galle
• Darlene Marie Gallina, LPN
• Christina Holden Ganzon, R.D.
• Vickie Jean Gavidia, RN
• Laura L Ghose, LMSW

• Registered Dietitian in Seneca Falls, NY
• Providers in Seneca Falls, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.