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

Mrs. Gina Angel Keatley, MBA, CDN

Individual provider Nutritionist · NPI 1164775649

Mrs. Gina Angel Keatley, MBA, CDN is a Registered Dietitian OR Nutrition Professional in New York, New York. Qualified in 2008, 18 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in New York.

Years since qualifying
18
Licensed in
NY
In the registry since
2012
Specialties on file
4
What do these letters mean?
MBA — Master of Business Administration
A graduate business degree.

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Practice location Address checks out

596 Broadway Ste 302
New York, NY 10012-3396
Phone: (800) 571-8276
Fax: (888) 974-0289
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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 007594 (NY)
Nutritionist Taxonomy 133N00000X · Licence 007594 (NY)
Renal Nutrition Registered Dietitian Taxonomy 133VN1005X · Licence 007594 (NY)
Metabolic Nutrition Registered Dietitian Taxonomy 133VN1006X · Licence 007594 (NY)

Record details

NPI number1164775649
Entity typeIndividual (Type 1)
GenderFemale
Credentials MBA , CDN
Sole proprietorYes
NPI enumeratedOctober 20, 2012
Last updated in NPPESJuly 10, 2020
Certification dateJuly 10, 2020

Medicare enrollment

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

Medicare specialtyREGISTERED DIETITIAN OR NUTRITION PROFESSIONAL
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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