Provider Demographics
NPI:1881654028
Name:PASSERRELLO, CAROLINE WEST (MS; RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:WEST
Last Name:PASSERRELLO
Suffix:
Gender:F
Credentials:MS; RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 KAPPA DRIVE
Mailing Address - Street 2:(C/O GIANT EAGLE)
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-2809
Mailing Address - Country:US
Mailing Address - Phone:412-967-4883
Mailing Address - Fax:
Practice Address - Street 1:101 CARA LIN DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-3688
Practice Address - Country:US
Practice Address - Phone:412-360-9052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
PADN003557133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA009686W68Medicare PIN
VAQ64349Medicare UPIN