Provider Demographics
NPI:1780645291
Name:EDDY, ANITA (RD CDN)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:EDDY
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 1:400 E MAIN ST
Mailing Address - Street 2:MEDICAL AFFAIRS NORTHERN WESTCHESTER HOSPITAL
Mailing Address - City:MT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549
Mailing Address - Country:US
Mailing Address - Phone:914-242-8318
Mailing Address - Fax:914-666-1965
Practice Address - Street 1:400 E MAIN ST
Practice Address - Street 2:NUTRITIONAL SERVICES DEPT NORTHERN WESTCHESTER HOSPITAL
Practice Address - City:MT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549
Practice Address - Country:US
Practice Address - Phone:914-666-1465
Practice Address - Fax:914-666-1787
Is Sole Proprietor?:No
Enumeration Date:2006-04-01
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000631133N00000X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY9530E1Medicare PIN
NY9530EFW071Medicare PIN
Q63931Medicare UPIN