Provider Demographics
NPI:1871692665
Name:NOTARO-BARTON, CHRISTINA M (RD, CDN)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:NOTARO-BARTON
Suffix:
Gender:F
Credentials:RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:TILLSON
Mailing Address - State:NY
Mailing Address - Zip Code:12486-1509
Mailing Address - Country:US
Mailing Address - Phone:845-658-7830
Mailing Address - Fax:
Practice Address - Street 1:243 MAIN ST
Practice Address - Street 2:SUITE 220
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-1325
Practice Address - Country:US
Practice Address - Phone:845-255-1978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005125-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY9246E1Medicare ID - Type Unspecified