Provider Demographics
NPI:1326774100
Name:LOCASCIO, ENZA (RD)
Entity Type:Individual
Prefix:
First Name:ENZA
Middle Name:
Last Name:LOCASCIO
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 1:17001 N 61ST ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-6446
Mailing Address - Country:US
Mailing Address - Phone:602-796-5999
Mailing Address - Fax:
Practice Address - Street 1:9075 S PARKSIDE LN E
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85326-2448
Practice Address - Country:US
Practice Address - Phone:623-258-2608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered