Provider Demographics
NPI:1538046750
Name:TISHFIELD, CAREN JO (RDN)
Entity type:Individual
Prefix:MRS
First Name:CAREN
Middle Name:JO
Last Name:TISHFIELD
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 MORNINGSIDE DR S
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-5417
Mailing Address - Country:US
Mailing Address - Phone:917-697-3048
Mailing Address - Fax:917-697-3048
Practice Address - Street 1:88 MORNINGSIDE DR S
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-5417
Practice Address - Country:US
Practice Address - Phone:917-697-3048
Practice Address - Fax:917-697-3048
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002169133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered