Active NPI
Zariel Carmen Grullon, RD
- Registered Dietitian
- Bronx, NY
National Provider Identifier
1710501507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86074779
- Practice address
- 871 Prospect Ave
Bronx, NY 10459-3913 - Phone
- (718) 991-0605
- NPI assigned
- Jun 8, 2020
- 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 | 86074779 | NY | Primary |
Addresses
Primary practice location
871 Prospect Ave
Bronx, NY 10459-3913
Mailing address
871 Prospect Ave
Bronx, NY 10459-3913
Phone (718) 991-0605
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 |
|---|---|---|---|
| 86074779 | NY | MD | Registered Dietitian |
| 010371 | NY | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Radicare, LLC | Dietitian, Registered | Current | Accepting new patients |
| Marjorie Nolan Cohn LLC | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591574400000",
"number": "1710501507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "871 PROSPECT AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104593913",
"telephone_number": "718-991-0605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "871 PROSPECT AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104593913",
"telephone_number": "718-991-0605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRULLON",
"first_name": "ZARIEL",
"middle_name": "CARMEN",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-08",
"last_updated": "2020-06-08",
"certification_date": "2020-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "86074779",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.