Provider Demographics
NPI:1053094896
Name:MISIANO, CAROLINE (RD)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:MISIANO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 LAKE MARIE LN
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:10507-1229
Mailing Address - Country:US
Mailing Address - Phone:914-393-9802
Mailing Address - Fax:
Practice Address - Street 1:2 LAKE MARIE LN
Practice Address - Street 2:
Practice Address - City:BEDFORD HILLS
Practice Address - State:NY
Practice Address - Zip Code:10507-1229
Practice Address - Country:US
Practice Address - Phone:914-393-9802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered