Provider Demographics
NPI:1437212867
Name:VONATSKI, PATRICIA ANN (RD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:VONATSKI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:ANN
Other - Last Name:SKOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:184 W MONTAUK HWY
Mailing Address - Street 2:
Mailing Address - City:HAMPTON BAYS
Mailing Address - State:NY
Mailing Address - Zip Code:11946-2304
Mailing Address - Country:US
Mailing Address - Phone:631-723-4200
Mailing Address - Fax:631-723-4205
Practice Address - Street 1:184 W MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:HAMPTON BAYS
Practice Address - State:NY
Practice Address - Zip Code:11946-2304
Practice Address - Country:US
Practice Address - Phone:631-723-4200
Practice Address - Fax:631-723-4205
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000771-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYS03031OtherHEALTHCHOICE
NY1934433OtherUNITED HEALTHCARE
NYP483850OtherOXFORD ALTERNATIVE
NYS0303OtherBLUE CHOICE DELUXE PPO
NY111667765092OtherCIGNA
NYP794179OtherOXFORD-COMMERCIAL
NY8099940OtherGHI
NY70792OtherVYTRA