Provider Demographics
NPI:1104011634
Name:RICE, CAROLYN LEE (RD REGISTERED DIETIT)
Entity Type:Individual
Prefix:MISS
First Name:CAROLYN
Middle Name:LEE
Last Name:RICE
Suffix:
Gender:F
Credentials:RD REGISTERED DIETIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:530 FAIRVIEW AVE
Mailing Address - Street 2:APT 300
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675
Mailing Address - Country:US
Mailing Address - Phone:914-573-6785
Mailing Address - Fax:201-358-1188
Practice Address - Street 1:530 FAIRVIEW AVE
Practice Address - Street 2:APT 300
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675
Practice Address - Country:US
Practice Address - Phone:914-573-6785
Practice Address - Fax:201-358-1188
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILR336700133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered