Provider Demographics
NPI:1457593386
Name:DANDAN, ALAMIRA RAAFAT (RD,CDN)
Entity Type:Individual
Prefix:
First Name:ALAMIRA
Middle Name:RAAFAT
Last Name:DANDAN
Suffix:
Gender:F
Credentials:RD,CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 RAMSEY AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-5244
Mailing Address - Country:US
Mailing Address - Phone:914-968-4378
Mailing Address - Fax:
Practice Address - Street 1:110 RAMSEY AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-5244
Practice Address - Country:US
Practice Address - Phone:914-968-4378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005345/1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered