Provider Demographics
NPI:1245269828
Name:GREENSPAN, KRISTIN LEIGH (RD)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:LEIGH
Last Name:GREENSPAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:GREENSPAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD
Mailing Address - Street 1:116 W 23RD ST
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-2599
Mailing Address - Country:US
Mailing Address - Phone:646-398-7929
Mailing Address - Fax:
Practice Address - Street 1:116 W 23RD ST
Practice Address - Street 2:5TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-2599
Practice Address - Country:US
Practice Address - Phone:696-398-7929
Practice Address - Fax:696-553-3313
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005621133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY132845837OtherPHCS
NY132845837OtherMULTIPLAN
NY8099760OtherGHI
NY8965265002OtherCIGNA
NY2529248OtherUNITED
NYGK5621OtherATLANTIS
NY132845837OtherHORIZON
NY7904658OtherAETNA
NY9489E1OtherBLUECROSS
NYP3587903OtherOXFORD
NY005621OtherHIP
NY132845837OtherBEECHSTREET
NY3800180OtherUSHC