Provider Demographics
NPI:1033974027
Name:CARBINE, CAITLIN (RDN)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:CARBINE
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 1:199 BARBERRY DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-4328
Mailing Address - Country:US
Mailing Address - Phone:302-354-7748
Mailing Address - Fax:
Practice Address - Street 1:2018 N HOPE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19122-1707
Practice Address - Country:US
Practice Address - Phone:302-354-7748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA86156921133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered