Provider Demographics
NPI:1184727042
Name:RAVNIK-LIST, ALENKA MARIA (MS, RD, CDN, CDE)
Entity type:Individual
Prefix:MRS
First Name:ALENKA
Middle Name:MARIA
Last Name:RAVNIK-LIST
Suffix:
Gender:F
Credentials:MS, RD, CDN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 OMNI PARC DR
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-5947
Mailing Address - Country:US
Mailing Address - Phone:845-425-6573
Mailing Address - Fax:
Practice Address - Street 1:ONE GUSTAVE LEVY PLACE, BOX 1067
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6574
Practice Address - Country:US
Practice Address - Phone:212-241-6162
Practice Address - Fax:212-426-7730
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005783133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic