Provider Demographics
NPI:1588494439
Name:BATTAGLIA, CARYN (RD CDN)
Entity type:Individual
Prefix:
First Name:CARYN
Middle Name:
Last Name:BATTAGLIA
Suffix:
Gender:F
Credentials:RD CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 JOSEPH PL
Mailing Address - Street 2:
Mailing Address - City:NESCONSET
Mailing Address - State:NY
Mailing Address - Zip Code:11767-2819
Mailing Address - Country:US
Mailing Address - Phone:516-859-4535
Mailing Address - Fax:
Practice Address - Street 1:97 JOSEPH PL
Practice Address - Street 2:
Practice Address - City:NESCONSET
Practice Address - State:NY
Practice Address - Zip Code:11767-2819
Practice Address - Country:US
Practice Address - Phone:516-859-4535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001786-01133VN1005X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered