Provider Demographics
NPI:1609212810
Name:SZAST, DOROTA PALEN (RDN, CDCES)
Entity Type:Individual
Prefix:
First Name:DOROTA
Middle Name:PALEN
Last Name:SZAST
Suffix:
Gender:F
Credentials:RDN, CDCES
Other - Prefix:
Other - First Name:DOROTHY
Other - Middle Name:
Other - Last Name:SZAST
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RDN, CDCES
Mailing Address - Street 1:1 CLARA MAASS DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-3550
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 CLARA MAASS DR
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-3550
Practice Address - Country:US
Practice Address - Phone:973-450-2126
Practice Address - Fax:973-450-2172
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-14
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1104379133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered