Provider Demographics
NPI:1801846308
Name:ORNSTEIN-NONNON, SUSAN
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:
Last Name:ORNSTEIN-NONNON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:ORNSTEIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS RD CDN
Mailing Address - Street 1:3824 213TH ST
Mailing Address - Street 2:SUITE 3G
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-2072
Mailing Address - Country:US
Mailing Address - Phone:718-423-7825
Mailing Address - Fax:718-423-7825
Practice Address - Street 1:3824 213TH ST
Practice Address - Street 2:SUITE 3G
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-2072
Practice Address - Country:US
Practice Address - Phone:718-423-7825
Practice Address - Fax:718-423-7825
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
724768OtherCOMMISSION OR DIETETIC OR
NY0000971OtherTHE STATE EDUCATOR DEPT
724768OtherCOMMISSION OR DIETETIC OR