Provider Demographics
NPI:1609767870
Name:BAYAT, SASHA (RDN)
Entity type:Individual
Prefix:
First Name:SASHA
Middle Name:
Last Name:BAYAT
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3636 33RD ST STE 311
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11106-2329
Mailing Address - Country:US
Mailing Address - Phone:609-293-5687
Mailing Address - Fax:
Practice Address - Street 1:36 W 33RD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3320
Practice Address - Country:US
Practice Address - Phone:609-293-5687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-14
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
MA86299437133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered