Provider Demographics
NPI:1477382612
Name:DRAGO, DEBRA ANN (RD, CDN)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANN
Last Name:DRAGO
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 1:1525 HENRY RD
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-3119
Mailing Address - Country:US
Mailing Address - Phone:516-567-1399
Mailing Address - Fax:
Practice Address - Street 1:1525 HENRY RD
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-3119
Practice Address - Country:US
Practice Address - Phone:516-567-1399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-27
Last Update Date:2024-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003093133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered