Provider Demographics
NPI:1841504404
Name:DEL PRETE, SHAUNA (RD)
Entity type:Individual
Prefix:
First Name:SHAUNA
Middle Name:
Last Name:DEL PRETE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:SHAUNA
Other - Middle Name:
Other - Last Name:MACE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:10 MELANIE LN
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-5830
Mailing Address - Country:US
Mailing Address - Phone:631-835-9191
Mailing Address - Fax:
Practice Address - Street 1:1160 AVALON SQ
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2845
Practice Address - Country:US
Practice Address - Phone:631-835-9191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-05
Last Update Date:2018-01-23
Deactivation Date:2017-12-06
Deactivation Code:
Reactivation Date:2018-01-23
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered