Provider Demographics
NPI:1215906102
Name:NATALE, DEENA ANISA (RD)
Entity type:Individual
Prefix:MRS
First Name:DEENA
Middle Name:ANISA
Last Name:NATALE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:NJ
Mailing Address - Zip Code:07644-3322
Mailing Address - Country:US
Mailing Address - Phone:973-246-6730
Mailing Address - Fax:373-246-6730
Practice Address - Street 1:133 CHURCH ST
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:NJ
Practice Address - Zip Code:07644-3322
Practice Address - Country:US
Practice Address - Phone:973-246-6730
Practice Address - Fax:373-246-6730
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ091147Medicare ID - Type UnspecifiedMNT