Provider Demographics
NPI:1770687246
Name:DIGREGORIO-CELNIK, DEBRA N (RD)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:N
Last Name:DIGREGORIO-CELNIK
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 1:1777 REISTERSTOWN RD STE 104
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-1317
Mailing Address - Country:US
Mailing Address - Phone:410-728-0531
Mailing Address - Fax:410-602-1966
Practice Address - Street 1:1777 REISTERSTOWN RD STE 104
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208-1317
Practice Address - Country:US
Practice Address - Phone:410-728-0531
Practice Address - Fax:410-602-1966
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD01489133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered