Provider Demographics
NPI:1770826802
Name:DAMASCOS, DRENA M (RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:DRENA
Middle Name:M
Last Name:DAMASCOS
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 MEADOW HALL DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20851
Mailing Address - Country:US
Mailing Address - Phone:301-340-1510
Mailing Address - Fax:301-340-1510
Practice Address - Street 1:15225 SHADY GROVE RD.
Practice Address - Street 2:#302
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850
Practice Address - Country:US
Practice Address - Phone:301-330-0550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal