Provider Demographics
NPI:1801263769
Name:DIMINO, ROSEANNE (BA CHHC AADP)
Entity type:Individual
Prefix:MRS
First Name:ROSEANNE
Middle Name:
Last Name:DIMINO
Suffix:
Gender:F
Credentials:BA CHHC AADP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 4TH ST
Mailing Address - Street 2:APT. 3B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-4586
Mailing Address - Country:US
Mailing Address - Phone:347-733-2907
Mailing Address - Fax:
Practice Address - Street 1:408 JAY ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5173
Practice Address - Country:US
Practice Address - Phone:347-733-2907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-26
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education