Provider Demographics
NPI:1255075867
Name:DON, DENA (MS, RDN, CDN)
Entity type:Individual
Prefix:MRS
First Name:DENA
Middle Name:
Last Name:DON
Suffix:
Gender:F
Credentials:MS, RDN, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 E END AVE APT 4T
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-7940
Mailing Address - Country:US
Mailing Address - Phone:516-316-8699
Mailing Address - Fax:
Practice Address - Street 1:30 E END AVE APT 4T
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-7940
Practice Address - Country:US
Practice Address - Phone:516-316-8699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-21
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011004133V00000X
86172316133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty