Provider Demographics
NPI:1538636006
Name:ARORA, MUDITA (MSC, MS, RDN, LD)
Entity Type:Individual
Prefix:MS
First Name:MUDITA
Middle Name:
Last Name:ARORA
Suffix:
Gender:F
Credentials:MSC, MS, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:197 ELLERSLIE PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-5715
Mailing Address - Country:US
Mailing Address - Phone:859-457-0115
Mailing Address - Fax:
Practice Address - Street 1:197 ELLERSLIE PARK BLVD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40515-5715
Practice Address - Country:US
Practice Address - Phone:859-457-0115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-01
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133NN1002X, 133VN1005X, 133VN1006X
KY123788133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic