Active NPI
Ivana Klaric-Mandic, M.S., R.D., C.D.N.
- Registered Dietitian
- Bronx, NY
National Provider Identifier
1740553908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 007075-1
- Practice address
- 1650 Selwyn Ave FL 10
Bronx, NY 10457-7626 - Phone
- (347) 673-3991
- NPI assigned
- Feb 20, 2012
- 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 | 007075-1 | NY | Primary |
Addresses
Primary practice location
1650 Selwyn Ave FL 10
Bronx, NY 10457-7626
Mailing address
3064 43Rd St Apt 3L
Astoria, NY 11103-2656
Phone (650) 862-9622
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007075-1 | NY | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404172800000",
"number": "1740553908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3064 43RD ST APT 3L",
"city": "ASTORIA",
"state": "NY",
"postal_code": "111032656",
"telephone_number": "650-862-9622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 SELWYN AVE FL 10",
"city": "BRONX",
"state": "NY",
"postal_code": "104577626",
"telephone_number": "347-673-3991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLARIC-MANDIC",
"first_name": "IVANA",
"credential": "M.S., R.D., C.D.N.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-20",
"last_updated": "2014-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "007075-1",
"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 Jul 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.