Provider Demographics
NPI:1962827998
Name:ASENCIO, JASON (MS, RDN, CSOWM)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:ASENCIO
Suffix:
Gender:M
Credentials:MS, RDN, CSOWM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:U.S. NAVAL HOSPITAL
Mailing Address - Street 2:VIA CONTRADA BOSCARIELLO
Mailing Address - City:GRICIGNANO DI AVERSA
Mailing Address - State:CE
Mailing Address - Zip Code:81030
Mailing Address - Country:IT
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:U.S. NAVAL HOSPITAL
Practice Address - Street 2:VIA CONTRADA BOSCARIELLO
Practice Address - City:GRICIGNANO DI AVERSA
Practice Address - State:CE
Practice Address - Zip Code:81030
Practice Address - Country:IT
Practice Address - Phone:081-811-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-27
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY876086133V00000X
FL6718133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered