Provider Demographics
NPI:1255594099
Name:DANCSAK, LORRAINE MARIE (MS RD CDE LDN)
Entity type:Individual
Prefix:MRS
First Name:LORRAINE
Middle Name:MARIE
Last Name:DANCSAK
Suffix:
Gender:F
Credentials:MS RD CDE LDN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:170 COLVIN RD
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:PA
Mailing Address - Zip Code:18414-9549
Mailing Address - Country:US
Mailing Address - Phone:570-563-0894
Mailing Address - Fax:570-563-0894
Practice Address - Street 1:170 COLVIN RD
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:PA
Practice Address - Zip Code:18414-9549
Practice Address - Country:US
Practice Address - Phone:570-563-0894
Practice Address - Fax:570-563-0894
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN000567133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic