Provider Demographics
NPI:1164724365
Name:NORKAITIS, DONNA LYNN (RD)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:LYNN
Last Name:NORKAITIS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:44 OTIS RD
Mailing Address - Street 2:
Mailing Address - City:EAST PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-6234
Mailing Address - Country:US
Mailing Address - Phone:516-663-4786
Mailing Address - Fax:516-663-8988
Practice Address - Street 1:1300 FRANKLIN AVE STE ML6
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-1760
Practice Address - Country:US
Practice Address - Phone:516-663-4786
Practice Address - Fax:516-663-8988
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-22
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004996-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered