Provider Demographics
NPI:1689334641
Name:FIORETTI, NICOLE (MS, RD)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:FIORETTI
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2771 SUNRISE ST
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-3324
Mailing Address - Country:US
Mailing Address - Phone:914-672-0961
Mailing Address - Fax:
Practice Address - Street 1:2771 SUNRISE ST
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-3324
Practice Address - Country:US
Practice Address - Phone:914-672-0961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-17
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86045452133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered