Provider Demographics
NPI:1205039419
Name:KATSIGEORGIS, EVANGELIA (RD, CDN)
Entity Type:Individual
Prefix:
First Name:EVANGELIA
Middle Name:
Last Name:KATSIGEORGIS
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 1:15730 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-1318
Mailing Address - Country:US
Mailing Address - Phone:718-304-5080
Mailing Address - Fax:
Practice Address - Street 1:15730 9TH AVE
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-1318
Practice Address - Country:US
Practice Address - Phone:718-304-5080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005177-1133N00000X
NY005177133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist