Provider Demographics
NPI:1619138971
Name:PAYTON, BRITTANY CANDICE (RD, CDN)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:CANDICE
Last Name:PAYTON
Suffix:
Gender:F
Credentials:RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8411 96TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODHAVEN
Mailing Address - State:NY
Mailing Address - Zip Code:11421-1725
Mailing Address - Country:US
Mailing Address - Phone:917-515-4690
Mailing Address - Fax:
Practice Address - Street 1:575 W 181ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-5002
Practice Address - Country:US
Practice Address - Phone:212-342-3061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY48 006463133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered