Provider Demographics
NPI:1568836203
Name:LOVELAND, LEA CHRISTY (RDN, CDN)
Entity Type:Individual
Prefix:
First Name:LEA
Middle Name:CHRISTY
Last Name:LOVELAND
Suffix:
Gender:F
Credentials:RDN, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10459-3978
Mailing Address - Country:US
Mailing Address - Phone:718-991-0605
Mailing Address - Fax:347-498-2751
Practice Address - Street 1:890 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10459-3978
Practice Address - Country:US
Practice Address - Phone:718-991-0605
Practice Address - Fax:347-498-2751
Is Sole Proprietor?:No
Enumeration Date:2015-11-18
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008515133NN1002X, 133V00000X, 133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY008515OtherC.D.N.
86015995OtherR.D.N