Stefanie Blake Tubin, RD, CDN, IBCLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

807729 Issued in NY

Practice address

9070 Michael Douglas Dr
Clarence Center, NY 14032-9276

Phone

(716) 741-0107

NPI assigned

Nov 5, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Blue Circle Dietetics & Nutrition PC

  • Registered Dietitian
  • East Aurora, NY
  • NPI 1578840450

  Dietitian, Registered

  NPD
• General Physician, PC

  • General Practice Physician
  • Dunkirk, NY
  • NPI 1093959322
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1352073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352073600000",
    "number": "1851645485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9070 MICHAEL DOUGLAS DR",
            "city": "CLARENCE CENTER",
            "state": "NY",
            "postal_code": "140329276",
            "telephone_number": "716-741-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9070 MICHAEL DOUGLAS DR",
            "city": "CLARENCE CENTER",
            "state": "NY",
            "postal_code": "140329276",
            "telephone_number": "716-741-0107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUBIN",
        "first_name": "STEFANIE",
        "middle_name": "BLAKE",
        "name_prefix": "Mrs.",
        "credential": "RD, CDN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-05",
        "last_updated": "2012-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "807729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucas John Speak, ARNP
• Sandra L Spoth, R.N., C.D.E.
• Patrick J Stein
• Maria Tierney, MS, CCC/SLP
• Allison Tobias
• Alexandra Scherer Viola, MT-BC
• Jennifer Whetham Jennifer Whetham
• Ernest G Zingapan, MD
• Michael Zlotkowski

• Registered Dietitian in Clarence Center, NY
• Providers in Clarence Center, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.