Provider Demographics
NPI:1336210467
Name:WINOCUR, REGINA (MA,RD,CDE)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:WINOCUR
Suffix:
Gender:F
Credentials:MA,RD,CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11724-1821
Mailing Address - Country:US
Mailing Address - Phone:631-374-6345
Mailing Address - Fax:
Practice Address - Street 1:29 BARSTOW RD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-2209
Practice Address - Country:US
Practice Address - Phone:631-374-6345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003616-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03P751OtherBLUE CROSS BLUE SHIELD
NY7986383003OtherCIGNA
NYP2066625OtherOXFORD HEALTH PLANS
NY270003616NY01OtherANTHEM
NY8000213OtherGHI
NY2125738OtherAETNA
NY127512OtherVYTRA
NY1938133OtherUNITED HEALTH CARE
NYAZ0089-2OtherMDNY
NY270003616NY01OtherANTHEM