Active NPI
Daetitian LLC
- Registered Dietitian
- Old Bridge, NJ
National Provider Identifier
1972312775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Legal business name
- DAETITIAN LLC
- Practice address
- 18 Daffodil Way
Old Bridge, NJ 08857-3592 - Phone
- (718) 300-1544
- NPI assigned
- Jan 6, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Viktoria Rusinova, RDN
- Title
- Member/Manager
- Phone
- (718) 300-1544
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | Primary |
Addresses
Primary practice location
18 Daffodil Way
Old Bridge, NJ 08857-3592
Mailing address
18 Daffodil Way
Old Bridge, NJ 08857-3592
Phone (718) 300-1544
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736121600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1736121600000",
"number": "1972312775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 DAFFODIL WAY",
"city": "OLD BRIDGE",
"state": "NJ",
"postal_code": "088573592",
"telephone_number": "718-300-1544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 DAFFODIL WAY",
"city": "OLD BRIDGE",
"state": "NJ",
"postal_code": "088573592",
"telephone_number": "718-300-1544"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DAETITIAN LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-01-06",
"last_updated": "2025-01-06",
"certification_date": "2025-01-06",
"status": "A",
"authorized_official_last_name": "RUSINOVA",
"authorized_official_first_name": "VIKTORIA",
"authorized_official_title_or_position": "MEMBER/MANAGER",
"authorized_official_telephone_number": "718-300-1544",
"authorized_official_credential": "RDN"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Old Bridge, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.