KATLYN CUSACK MS RDN LDN PA-C NPI 1104489426

NPI Information

  • NPI: 1104489426
  • Provider Name: KATLYN CUSACK, MS, RDN, LDN, PA-C
  • Classification: Physician Assistant - 363A00000X
  • Entity Type: Individual
  • Address: 703 MAIN ST
    PATERSON, NJ
    ZIP 07503
  • Phone: (732) 539-3584

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NPI Details

Katlyn Cusack, MS, RDN, LDN, PA-C is a physician assistant in Paterson, NJ. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. Katlyn Cusack, MS, RDN, LDN, PA-C NPI is 1104489426. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

703 MAIN ST
PATERSON, NJ
ZIP 07503-621
Phone: (732) 539-3584

The enumeration date for this NPI number is 4/22/2019 and was last updated on 1/28/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AS0400XPhysician AssistantSurgical25MP00909300NEW JERSEYNo
2363A00000XPhysician Assistant25MP00909300NEW JERSEYYes
3363AM0700XPhysician AssistantMedical25MP00909300NEW JERSEYNo
4133V00000XDietitian, Registered86103286NEW JERSEYNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
186103286OTHERNEW JERSEYCDR

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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