Provider Demographics
NPI:1205442639
Name:SCALI, DOMENICK SALVATOR (RDN)
Entity type:Individual
Prefix:MR
First Name:DOMENICK
Middle Name:SALVATOR
Last Name:SCALI
Suffix:
Gender:M
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 GARDEN RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE SILVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07739-1035
Mailing Address - Country:US
Mailing Address - Phone:732-710-8598
Mailing Address - Fax:
Practice Address - Street 1:80 GARDEN RD
Practice Address - Street 2:
Practice Address - City:LITTLE SILVER
Practice Address - State:NJ
Practice Address - Zip Code:07739-1035
Practice Address - Country:US
Practice Address - Phone:732-710-8598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered