Individual provider Active NPI

Susan Weiner, R.D. M.S. C.D.E.

  • Metabolic Nutrition Registered Dietitian
  • Merrick, NY
National Provider Identifier
1649487281
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X
License
002155-1 Issued in NY
Practice address
124 Merrick Ave
Room #5
Merrick, NY 11566-3434
Phone
(516) 221-9288
Fax
(516) 221-5073
NPI assigned
May 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Metabolic Nutrition Registered Dietitian 133VN1006X 002155-1 NY Primary

Addresses

Primary practice location

124 Merrick Ave
Room #5
Merrick, NY 11566-3434

Mailing address

124 Merrick Ave
Room #5
Merrick, NY 11566-3434
Phone (516) 221-9288

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

LicenseStateTypeSpecialty
002155-1NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649487281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 MERRICK AVE",
            "address_2": "ROOM #5",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115663434",
            "telephone_number": "516-221-9288",
            "fax_number": "516-221-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 MERRICK AVE",
            "address_2": "ROOM #5",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115663434",
            "telephone_number": "516-221-9288",
            "fax_number": "516-221-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINER",
        "first_name": "SUSAN",
        "name_prefix": "Mrs.",
        "credential": "R.D. M.S. C.D.E.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "NY",
            "license": "002155-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrick, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.