Provider Demographics
NPI:1407448665
Name:TSAPARIKOS, STEVEN ROBERT (RDN, CHC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:ROBERT
Last Name:TSAPARIKOS
Suffix:
Gender:M
Credentials:RDN, CHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3006 BAVARIAN EAST DR APT 214
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46235-3433
Mailing Address - Country:US
Mailing Address - Phone:219-210-6460
Mailing Address - Fax:
Practice Address - Street 1:4055 SOUTH ROY WILSON WAY
Practice Address - Street 2:
Practice Address - City:NEW PALESTINE
Practice Address - State:IN
Practice Address - Zip Code:46163-8031
Practice Address - Country:US
Practice Address - Phone:317-866-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN86117721133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered