IndividualActive
Samantha Vallejo, RDN
NPI 1174298491 · Obesity and Weight Management Nutrition Registered Dietitian · Medford, NY
Provider details
- NPI number
- 1174298491
- Entity type
- Individual
- Primary specialty
- Obesity and Weight Management Nutrition Registered DietitianDietary & Nutritional Service Providers
- Credential
- RDN
- Sex
- Female
- Sole proprietor
- Yes
- License
- 086073674 (NY)
Specialties & taxonomies
Dietary & Nutritional Service Providers
Dietary & Nutritional Service Providers
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3108 Gull Ave
Medford, NY 11763-1731
Phone: (631) 294-2090
Street-level locationGet directions
Mailing address
3108 Gull Ave
Medford, NY 11763-1731
Registry dates
- Enumerated
- 2021-08-09
- Last updated
- 2021-08-09
- Certified
- 2021-08-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.