Provider Demographics
NPI:1801096755
Name:OCONNOR, NANCY E (RD, CDN)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:E
Last Name:OCONNOR
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 1:23050 HICKORY DR # DE
Mailing Address - Street 2:
Mailing Address - City:DEXTER
Mailing Address - State:NY
Mailing Address - Zip Code:13634-3300
Mailing Address - Country:US
Mailing Address - Phone:315-639-6166
Mailing Address - Fax:
Practice Address - Street 1:23050 HICKORY DR
Practice Address - Street 2:
Practice Address - City:DEXTER
Practice Address - State:NY
Practice Address - Zip Code:13634-3300
Practice Address - Country:US
Practice Address - Phone:315-639-6166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered