Provider Demographics
NPI:1477109890
Name:DHAR, INDRANI (MS RD CDE)
Entity Type:Individual
Prefix:
First Name:INDRANI
Middle Name:
Last Name:DHAR
Suffix:
Gender:F
Credentials:MS RD CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 N PEARL ST APT 402
Mailing Address - Street 2:
Mailing Address - City:PORT CHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10573-4194
Mailing Address - Country:US
Mailing Address - Phone:845-224-5754
Mailing Address - Fax:
Practice Address - Street 1:120 N PEARL ST APT 402
Practice Address - Street 2:
Practice Address - City:PORT CHESTER
Practice Address - State:NY
Practice Address - Zip Code:10573-4194
Practice Address - Country:US
Practice Address - Phone:845-224-5754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-12
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007970-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered