Provider Demographics
NPI:1265004089
Name:CUEVAS, ANNETTE (RD, CDN, IBCLC)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:CUEVAS
Suffix:
Gender:F
Credentials:RD, CDN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 COLUMBUS AVE LOWR LEVEL
Mailing Address - Street 2:
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1326
Mailing Address - Country:US
Mailing Address - Phone:914-347-0162
Mailing Address - Fax:914-347-4401
Practice Address - Street 1:401 COLUMBUS AVE LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1326
Practice Address - Country:US
Practice Address - Phone:914-347-0162
Practice Address - Fax:914-347-4401
Is Sole Proprietor?:No
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY873175133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered