Provider Demographics
NPI:1801087515
Name:CAGGIANO, ANTONELLA C (MS, RD, CDN)
Entity type:Individual
Prefix:MS
First Name:ANTONELLA
Middle Name:C
Last Name:CAGGIANO
Suffix:
Gender:F
Credentials:MS, RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 E BOSTON POST RD
Mailing Address - Street 2:1-6
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-4149
Mailing Address - Country:US
Mailing Address - Phone:914-715-3069
Mailing Address - Fax:
Practice Address - Street 1:1035 E BOSTON POST RD
Practice Address - Street 2:1-6
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-4149
Practice Address - Country:US
Practice Address - Phone:914-715-3069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY896820133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered