Provider Demographics
NPI:1982285763
Name:SOBIESKI, DANIELLE TRACEY (RDN)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:TRACEY
Last Name:SOBIESKI
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 PLAZA ST E STE 1A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-5039
Mailing Address - Country:US
Mailing Address - Phone:646-933-3176
Mailing Address - Fax:646-558-4260
Practice Address - Street 1:36 PLAZA ST E STE 1A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-5039
Practice Address - Country:US
Practice Address - Phone:646-933-3176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-14
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008634133V00000X
86046987133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered