Provider Demographics
NPI:1477192599
Name:KEATS, SHARI (MS, RDN, CDN)
Entity type:Individual
Prefix:
First Name:SHARI
Middle Name:
Last Name:KEATS
Suffix:
Gender:
Credentials:MS, RDN, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 TRAILHEAD LN
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5048
Mailing Address - Country:US
Mailing Address - Phone:917-733-8656
Mailing Address - Fax:
Practice Address - Street 1:40 TRAILHEAD LN
Practice Address - Street 2:
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-5048
Practice Address - Country:US
Practice Address - Phone:917-733-8656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-06
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009830-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered