Provider Demographics
NPI:1043979529
Name:FAUSTINI, PAIGE (RDN)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:FAUSTINI
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 1:61 HALLOCKS RUN
Mailing Address - Street 2:
Mailing Address - City:SOMERS
Mailing Address - State:NY
Mailing Address - Zip Code:10589-2824
Mailing Address - Country:US
Mailing Address - Phone:914-417-1360
Mailing Address - Fax:
Practice Address - Street 1:61 HALLOCKS RUN
Practice Address - Street 2:
Practice Address - City:SOMERS
Practice Address - State:NY
Practice Address - Zip Code:10589-2824
Practice Address - Country:US
Practice Address - Phone:914-417-1360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-13
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY86106612133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered