Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mario E. Landaverde, RDN

Individual provider Registered Dietitian · NPI 1972121903

Mario E. Landaverde, RDN is a Registered Dietitian OR Nutrition Professional in New York, New York. Qualified in 2021, 5 years ago. Practices with Boro Park Nutrition LLC, a 9-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
5
Licensed in
NY
In the registry since
2020
What do these letters mean?
RDN — Registered Dietitian Nutritionist
The current title for a registered dietitian.

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Practice location Address checks out

135 W 96th St Apt 8B
New York, NY 10025-9221
Phone: (917) 691-9776
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence 86062371 (NY)

Record details

NPI number1972121903
Entity typeIndividual (Type 1)
GenderMale
Credentials RDN
Sole proprietorYes
NPI enumeratedJuly 7, 2020
Last updated in NPPESJuly 7, 2020
Certification dateJuly 7, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyREGISTERED DIETITIAN OR NUTRITION PROFESSIONAL
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Boro Park Nutrition Llc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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