Provider Demographics
NPI:1285010280
Name:NARAYANAN, SANDHYA (RDN)
Entity Type:Individual
Prefix:
First Name:SANDHYA
Middle Name:
Last Name:NARAYANAN
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 1:6040 KENNEDY BLVD E
Mailing Address - Street 2:25G
Mailing Address - City:WEST NEW YORK
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-3825
Mailing Address - Country:US
Mailing Address - Phone:201-993-7640
Mailing Address - Fax:
Practice Address - Street 1:6040 KENNEDY BLVD E
Practice Address - Street 2:25G
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-3825
Practice Address - Country:US
Practice Address - Phone:201-993-7640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-03
Last Update Date:2016-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEDN-0000586133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered