Kristen H O'Dell
Individual provider Active NPI Registered Dietitian · Blasdell, NY
NPI 1780246934 · NPPES record last updated Jul 8, 2019
Key facts
- NPI
- 1780246934
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 86008465 (NY)
- Practice address
- 12 Madison Ave
Blasdell, NY 14219-1716 - Phone
- (908) 894-9054
- NPI assigned
- Jul 8, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86008465 | NY | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86008465 | NY | Yes |
Addresses
Primary practice location
12 Madison Ave
Blasdell, NY 14219-1716
Mailing address
12 Madison Ave
Blasdell, NY 14219-1716
Phone (908) 894-9054
Other providers in Blasdell, NY
- Newton Abbott Fire Co., Inc.
- Julia Newton
- Carly Nicholas
- Rhiannon Rose Nowakowski
- Nupur Technologies LLC
- Park Sher Optical Co of Buffalo Ny Inc
- Amy L Parry
- Hunter Pasternak
- Haley Peer
- Paul Piechalak
All providers in Blasdell, 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 Jul 8, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.