Provider Demographics
NPI:1912448515
Name:CASPER, MEGAN ANNE (RDN)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:ANNE
Last Name:CASPER
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 1:6613 OCEAN AVE N
Mailing Address - Street 2:# 1
Mailing Address - City:ARVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11692-2043
Mailing Address - Country:US
Mailing Address - Phone:646-943-3408
Mailing Address - Fax:
Practice Address - Street 1:6613 OCEAN AVE N
Practice Address - Street 2:# 1
Practice Address - City:ARVERNE
Practice Address - State:NY
Practice Address - Zip Code:11692-2043
Practice Address - Country:US
Practice Address - Phone:646-943-3408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-15
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered