Provider Demographics
NPI:1952493314
Name:CULLEN, KRISTEN (RD, CDN, CDE)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:CULLEN
Suffix:
Gender:
Credentials:RD, CDN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BARRETT HILL RD
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-6953
Mailing Address - Country:US
Mailing Address - Phone:845-418-0797
Mailing Address - Fax:
Practice Address - Street 1:11 BARRETT HILL RD
Practice Address - Street 2:
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-6953
Practice Address - Country:US
Practice Address - Phone:845-418-0797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00186301133V00000X
NY812395133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered