National Provider Identifier
Clinton Harold Wattenberg, RD
Clinton Harold Wattenberg, RD is listed in the NPPES registry with a primary specialty of Registered Dietitian in Ithaca, NY and a listed phone number of (607) 227-9344.
Profile Overview
- NPI
- 1942580501
- Provider Type
- Individual
- Primary Specialty
- Registered Dietitian
- Enumeration Date
- August 26, 2011
- Last Updated
- August 26, 2011
Practice Location
- 949 E State St
- Ithaca, NY 14850-6158
Phone: (607) 227-9344
Specialties
- Registered Dietitian (133V00000X)
- Metabolic Nutrition Registered Dietitian (133VN1006X)
- Pediatric Nutrition Registered Dietitian (133VN1004X)
- Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
- NPI
- 1942580501
- Entity Type
- Individual
- Last Name
- Wattenberg
- First Name
- Clinton
- Middle Name
- Harold
- Name Prefix
- Mr.
- Credential
- RD
- Mailing Street Address
- 949 E State St
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-6158
- Mailing Country
- US
- Mailing Phone
- (607) 227-9344
- Practice Street Address
- 949 E State St
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-6158
- Practice Country
- US
- Practice Phone
- (607) 227-9344
- Enumeration Date
- August 26, 2011
- Last Updated
- August 26, 2011
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Registered Dietitian (133V00000X), Metabolic Nutrition Registered Dietitian (133VN1006X), Pediatric Nutrition Registered Dietitian (133VN1004X), Student in an Organized Health Care Education/Training Program (390200000X)