Rena Marie Riccardi, MS, RD, CDE

Primary specialty

Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X

License

724462

Practice address

255 Lafayette Ave
Suffern, NY 10901-4869

Phone

(914) 772-1005

Fax

(845) 547-3357

NPI assigned

Jul 17, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 8

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531785600000",
    "number": "1962988543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 JUNIPER DR",
            "city": "LAKE LINCOLNDALE",
            "state": "NY",
            "postal_code": "105415300",
            "telephone_number": "914-772-1005",
            "fax_number": "914-556-6356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 LAFAYETTE AVE",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109014869",
            "telephone_number": "914-772-1005",
            "fax_number": "845-547-3357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICCARDI",
        "first_name": "RENA",
        "middle_name": "MARIE",
        "credential": "MS, RD, CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-17",
        "last_updated": "2018-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": "724462",
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080B0002X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Obesity Medicine",
            "state": "NY",
            "license": "724462",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "NY",
            "license": "217003387",
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": null,
            "license": "724462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDR",
            "identifier": "724462",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCBDE",
            "identifier": "21700387",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Renata Witkowska Asthma Allergy and Sinus PLLC
• Lakasha Rennock, RN
• Jessica Resto, RN
• John Joseph Reynolds, PHYSICIAN ASSISTANT
• Karen C.F. Rhodes, PH.D.
• Arlene Diana Riccio, CRNA
• Melissa Riccio
• Jermaine Ricketts, LPN
• Diane Rilloraza, RN
• Eileen Riman, FNP

• Metabolic Nutrition Registered Dietitian in Suffern, NY
• Providers in Suffern, NY by specialty
• Metabolic Nutrition Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2018; 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.