Provider Demographics
NPI:1174193395
Name:PINCAY, JICENIS G (MS, RDN, CDCES)
Entity Type:Individual
Prefix:MRS
First Name:JICENIS
Middle Name:G
Last Name:PINCAY
Suffix:
Gender:F
Credentials:MS, RDN, CDCES
Other - Prefix:MRS
Other - First Name:JICENIS
Other - Middle Name:G
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RDN, CDCES
Mailing Address - Street 1:8606 86TH AVE
Mailing Address - Street 2:
Mailing Address - City:WOODHAVEN
Mailing Address - State:NY
Mailing Address - Zip Code:11421-1258
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2000 N VILLAGE AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-1078
Practice Address - Country:US
Practice Address - Phone:516-705-2177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered