Provider Demographics
NPI:1184245706
Name:BISHOP, KATHERINE (RDN, CDN)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:BISHOP
Suffix:
Gender:F
Credentials:RDN, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 OAK ST
Mailing Address - Street 2:
Mailing Address - City:HARRINGTON PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07640-1108
Mailing Address - Country:US
Mailing Address - Phone:203-536-6605
Mailing Address - Fax:
Practice Address - Street 1:6 OAK ST
Practice Address - Street 2:
Practice Address - City:HARRINGTON PARK
Practice Address - State:NJ
Practice Address - Zip Code:07640-1108
Practice Address - Country:US
Practice Address - Phone:203-536-6605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY86073255133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered