Provider Demographics
NPI:1114154689
Name:EATEDALI, NATALIE (MS, RD, CDN)
Entity type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:
Last Name:EATEDALI
Suffix:
Gender:
Credentials:MS, RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9205 MISTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2883
Mailing Address - Country:US
Mailing Address - Phone:202-681-6126
Mailing Address - Fax:
Practice Address - Street 1:9205 MISTWOOD DR
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-2883
Practice Address - Country:US
Practice Address - Phone:202-681-6126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-11
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY948784133V00000X
MDDX4006133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered