Provider Demographics
NPI:1083799274
Name:RESTUCCIA, NANCY LYNN (RD)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:LYNN
Last Name:RESTUCCIA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 FORT WASHINGTON AVE
Mailing Address - Street 2:SUITE 524
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3729
Mailing Address - Country:US
Mailing Address - Phone:212-305-0118
Mailing Address - Fax:212-342-1996
Practice Address - Street 1:161 FORT WASHINGTON AVE
Practice Address - Street 2:SUITE 524
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3729
Practice Address - Country:US
Practice Address - Phone:212-305-0118
Practice Address - Fax:212-342-1996
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered