Active NPI
Celine E Iledan, RD,CDN
- Registered Dietitian
- Ny, NY
National Provider Identifier
1659595221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 821891
- Practice address
- 83 Maiden Lane 5TH Floor
Ny, NY 10038-4812 - Phone
- (212) 780-2708
- NPI assigned
- Apr 12, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 821891 | IL | Primary |
Addresses
Primary practice location
83 Maiden Lane 5TH Floor
Ny, NY 10038-4812
Mailing address
4410 Ketcham St
5A
Elmhurst, NY 11373-3660
Phone (718) 429-6234
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 821891 | IL | MD | Registered Dietitian |
| 000545 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nysarc Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Voluntary or Charitable Agency
- New York, NY
- NPI 1457450124
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659595221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4410 KETCHAM ST",
"address_2": "5A",
"city": "ELMHURST",
"state": "NY",
"postal_code": "113733660",
"telephone_number": "718-429-6234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "83 MAIDEN LANE 5TH FLOOR",
"city": "NY",
"state": "NY",
"postal_code": "100384812",
"telephone_number": "212-780-2708"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ILEDAN",
"first_name": "CELINE",
"middle_name": "E",
"credential": "RD,CDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "821891",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ny, 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.