Joan Stollberger, R.D., C.D.E.
Individual provider Active NPI Registered Dietitian · Calverton, NY
NPI 1710013339 · NPPES record last updated Jan 8, 2019
Key facts
- NPI
- 1710013339
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 003655-1 (NY)
- Practice address
- 202 Fox Hill Dr
Calverton, NY 11933-9503 - Phone
- (631) 979-9512
- Fax
- (631) 979-9512
- NPI assigned
- Feb 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050608001096 | NY | Practitioner - Registered Dietitian Or Nutrition Professional | 0345283461 | Practice locations: Calverton, NY |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003655-1 | NY | MD | Registered Dietitian |
| 003655 | NY | MD | Podiatrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 003655-1 | NY | Yes |
Addresses
Primary practice location
202 Fox Hill Dr
Calverton, NY 11933-9503
Mailing address
202 Fox Hill Dr
Calverton, NY 11933-9503
Phone (631) 979-9512
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P2211060 | Other | NY | OXFORD |
Other providers in Calverton, NY
- Richard Carroll Sears Jr.
- Djamshid Shirazian
- Rohan Jeet Singh
- Janette M Sperandeo
- Maria Jean Stewart
- Strategic Senior Services LLC
- Patricia Sullivan
- Marina L Torre
- Ramona Torres
- Diana Marie Vanvliet
All providers in Calverton, NY · Registered Dietitian in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.