Provider Demographics
NPI:1255977948
Name:INGENITO, CARMINE (MS, RD)
Entity type:Individual
Prefix:
First Name:CARMINE
Middle Name:
Last Name:INGENITO
Suffix:
Gender:M
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 W 57TH ST STE 1211
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-2820
Mailing Address - Country:US
Mailing Address - Phone:646-361-6803
Mailing Address - Fax:
Practice Address - Street 1:22 WASHINGTON PL E # 2B
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10603-1715
Practice Address - Country:US
Practice Address - Phone:914-772-7528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-18
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY86053618OtherCOMMISSION ON DIETETIC REGISTRATION, REGISTRATION EXAMINATION FOR DIETITIANS
NY1097877OtherCERTIFIED DIETITIAN-NUTRITIONIST'