Provider Demographics
NPI:1598198285
Name:WATTEL, NATASHA (RD, CDN, CDE)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:WATTEL
Suffix:
Gender:F
Credentials:RD, CDN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 E 24TH ST
Mailing Address - Street 2:APT. 10C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-3611
Mailing Address - Country:US
Mailing Address - Phone:646-206-1593
Mailing Address - Fax:
Practice Address - Street 1:1400 PELHAM PKWY S, BLDG 8, 3RD FL., ROOM 3C128
Practice Address - Street 2:JACOBI MEDICAL CENTER
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-918-5459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-16
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007747133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered