Provider Demographics
NPI:1891262150
Name:TATOSIAN, DANICE (CDN)
Entity Type:Individual
Prefix:
First Name:DANICE
Middle Name:
Last Name:TATOSIAN
Suffix:
Gender:F
Credentials:CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 FIELDSTONE DR APT 53
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-1520
Mailing Address - Country:US
Mailing Address - Phone:914-468-4413
Mailing Address - Fax:
Practice Address - Street 1:55 FIELDSTONE DR APT 53
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-1520
Practice Address - Country:US
Practice Address - Phone:203-253-7585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-25
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008083133NN1002X, 133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education