Igor Kezin, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

009411-01 Issued in NY

Practice address

305 E 104TH St Apt 2E
New York, NY 10029-5537

Phone

(347) 235-2820

NPI assigned

Jul 22, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1861220923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 E 104TH ST APT 2E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100295537",
            "telephone_number": "347-235-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E 104TH ST APT 2E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100295537",
            "telephone_number": "347-235-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEZIN",
        "first_name": "IGOR",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CT",
            "license": "001724",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "009411-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in New York, NY
• Providers in New York, 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 Jul 22, 2024; 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.