Provider Demographics
NPI:1013355395
Name:JOURNEY, KARLA E (RDN)
Entity Type:Individual
Prefix:MS
First Name:KARLA
Middle Name:E
Last Name:JOURNEY
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 AZALEA CT
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-1633
Mailing Address - Country:US
Mailing Address - Phone:917-543-1077
Mailing Address - Fax:
Practice Address - Street 1:17 AZALEA CT
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-1633
Practice Address - Country:US
Practice Address - Phone:917-543-1077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY819018133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered