NPI 1831066828 · live from the CMS NPI Registry
Victoria Rose Banaczuk, MS, RD, LDN
Dietitian, Registered in Providence, RI. National Provider Identifier 1831066828, active.
NPI record
| NPI | 1831066828 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 593 Eddy St, Providence, RI 02903 |
| Practice phone | 401-444-5603 |
| Mailing address | 15 La Salle Sq, Providence, RI 02903 |
| Enumerated | October 22, 2025 |
| Last updated | December 1, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | LDN01611 (RI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.