Provider Demographics
NPI:1053771261
Name:KARP, AMANDA PAIGE (MS, RD, CDN)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:PAIGE
Last Name:KARP
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 1:24 THE SERPENTINE
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-1709
Mailing Address - Country:US
Mailing Address - Phone:516-236-7611
Mailing Address - Fax:
Practice Address - Street 1:24 THE SERPENTINE
Practice Address - Street 2:
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-1709
Practice Address - Country:US
Practice Address - Phone:516-236-7611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-01
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, PediatricGroup - Single Specialty