Provider Demographics
NPI:1861543175
Name:PATTI-TREPICCIONE, KERRILYNN (RD)
Entity type:Individual
Prefix:MRS
First Name:KERRILYNN
Middle Name:
Last Name:PATTI-TREPICCIONE
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 1:4 WALBASH CT
Mailing Address - Street 2:
Mailing Address - City:MOUNT SINAI
Mailing Address - State:NY
Mailing Address - Zip Code:11766-2917
Mailing Address - Country:US
Mailing Address - Phone:631-848-8795
Mailing Address - Fax:
Practice Address - Street 1:4 WALBASH CT
Practice Address - Street 2:
Practice Address - City:MOUNT SINAI
Practice Address - State:NY
Practice Address - Zip Code:11766-2917
Practice Address - Country:US
Practice Address - Phone:631-848-8795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY944786133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered