Provider Demographics
NPI:1174271027
Name:NOCCO, PAUL (RDN)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:NOCCO
Suffix:
Gender:M
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 STONEWALL CIR
Mailing Address - Street 2:
Mailing Address - City:WEST HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10604-1124
Mailing Address - Country:US
Mailing Address - Phone:914-715-9001
Mailing Address - Fax:
Practice Address - Street 1:720 MONROE ST STE E512
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-6360
Practice Address - Country:US
Practice Address - Phone:914-715-9001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-10
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY86152389133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty