Organization Active NPI

Daetitian LLC

  • Registered Dietitian
  • Old Bridge, NJ
National Provider Identifier
1972312775
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
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

Updated by the provider on Jan 6, 2025

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

Authorized official

Name
Viktoria Rusinova, RDNNPI 1861201659
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)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 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 Directory

Practitioners & 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.

Verify at the official NPI Registry.