MRS. MARIANA OLGA SERBACK MS, RDN NPI 1003448085

Dietitian, Registered in Watertown, NY

Individual Female Dietitian, Registered

About MARIANA SERBACK

Mariana Serback is a provider established in Watertown, New York and her medical specialization is dietitian, registered. The NPI number of Mariana Serback is 1003448085 and was assigned on February 2020. The practitioner's primary taxonomy code is 133V00000X with license number 86050685 (NY). The provider is registered as an individual and her NPI record was last updated February 2020.

NPI

1003448085

Provider NameMRS. MARIANA OLGA SERBACK MS, RDN
Provider Location Address19500 WOODSIDE DR WATERTOWN, NY 13601
Provider Mailing Address19500 WOODSIDE DR WATERTOWN, NY 13601
GenderFemale
NPI Entity TypeIndividual
Is Sole Proprietor?Yes
Is Organization Subpart?N/A
Enumeration Date02-07-2020
Last Update Date02-07-2020

Primary Taxonomy

Taxonomy Code133V00000X
ClassificationDietitian, Registered
TypeDietary & Nutritional Service Providers
License No.86050685
License StateNY
Taxonomy DescriptionA Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

Business Address

MRS. MARIANA OLGA SERBACK MS, RDN
19500 WOODSIDE DR
WATERTOWN, NY
ZIP 13601
Phone: (315) 778-9218

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Mailing Address

MRS. MARIANA OLGA SERBACK MS, RDN
19500 WOODSIDE DR
WATERTOWN, NY
ZIP 13601
Phone: (315) 778-9218

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.