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Contact Information

KATHERINE V BACON, MS, RDN
251 N TITMUS DR
MASTIC, NY11950-1515
 Phone: 631-377-1793
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dietitian, Registered

133V00000X 71 Registered Dietitian or Nutrition Professional
Indicates primary specialty

NPI Profile & details for KATHERINE V BACON · (Female)

NPI # 1245174648
Status Active
Credentials MS, RDN
Entity Individual
Enumeration date 04/16/2026
Last updated 04/16/2026 - About 2 months ago
Sole proprietor 1 No
Identifiers
  • NY License # 86392502
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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