Provider Demographics
NPI:1588021075
Name:NASSAR, CARINE M (RD)
Entity Type:Individual
Prefix:MRS
First Name:CARINE
Middle Name:M
Last Name:NASSAR
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
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Mailing Address - Street 1:100 IRVING ST NW
Mailing Address - Street 2:EB 4114
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-3017
Mailing Address - Country:US
Mailing Address - Phone:202-877-0351
Mailing Address - Fax:202-877-6775
Practice Address - Street 1:100 IRVING ST NW
Practice Address - Street 2:EB 4114
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-3017
Practice Address - Country:US
Practice Address - Phone:202-877-0351
Practice Address - Fax:202-877-6775
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-28
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDI374133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered