Provider Demographics
NPI:1508974957
Name:MAROTTA, CHRISTINE G (RD,CDE,CDN)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:G
Last Name:MAROTTA
Suffix:
Gender:F
Credentials:RD,CDE,CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 NEW KARNER RD
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-3882
Mailing Address - Country:US
Mailing Address - Phone:518-452-1337
Mailing Address - Fax:518-724-6660
Practice Address - Street 1:501 NEW KARNER RD
Practice Address - Street 2:SUITE 1A
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-3882
Practice Address - Country:US
Practice Address - Phone:518-452-1337
Practice Address - Fax:518-724-6660
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY819135133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000496752002OtherBSNENY
NY10043476OtherCDPHP
NY4130205OtherMVP HEALTCARE
NY87962OtherGHI/HMO
NY4130205OtherMVP HEALTCARE