Provider Demographics
NPI:1780444117
Name:LIVANOS, CHRISTINE OVALLE (RD/RDN, CDN)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:OVALLE
Last Name:LIVANOS
Suffix:
Gender:F
Credentials:RD/RDN, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 MIDLAND AVE APT 3L
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-6323
Mailing Address - Country:US
Mailing Address - Phone:917-951-5375
Mailing Address - Fax:
Practice Address - Street 1:1111 MIDLAND AVE
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-6333
Practice Address - Country:US
Practice Address - Phone:917-951-5375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-21
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty