Provider Demographics
NPI:1952983868
Name:ORLICK LEVY, DEBORAH (RDN)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:ORLICK LEVY
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:LYNN
Other - Last Name:ORLICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN
Mailing Address - Street 1:220 MCKENNA DR
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07648-1823
Mailing Address - Country:US
Mailing Address - Phone:646-245-2180
Mailing Address - Fax:
Practice Address - Street 1:220 MCKENNA DR
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07648-1823
Practice Address - Country:US
Practice Address - Phone:646-245-2180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
819408133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered