Provider Demographics
NPI:1033342472
Name:CONOVER, ANASTASIA P (MS, RD)
Entity Type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:P
Last Name:CONOVER
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 BURDETTE RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20851-1031
Mailing Address - Country:US
Mailing Address - Phone:610-322-3090
Mailing Address - Fax:
Practice Address - Street 1:800 BURDETTE RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20851-1031
Practice Address - Country:US
Practice Address - Phone:610-322-3090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-02
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY963115133V00000X
MDDX3597133V00000X
DCDI100000567133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered