Provider Demographics
NPI:1184997249
Name:ENGELHAUPT, ANNA KATARZYNA (MS, RD, CDN)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:KATARZYNA
Last Name:ENGELHAUPT
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 1:2950 ELMWOOD AVE
Mailing Address - Street 2:NUTRITION SERVICES
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217-1304
Mailing Address - Country:US
Mailing Address - Phone:716-447-6539
Mailing Address - Fax:716-447-6314
Practice Address - Street 1:2950 ELMWOOD AVE
Practice Address - Street 2:NUTRITION SERVICES
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217-1304
Practice Address - Country:US
Practice Address - Phone:716-447-6539
Practice Address - Fax:716-447-6314
Is Sole Proprietor?:No
Enumeration Date:2012-02-20
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY48006440133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered