Provider Demographics
NPI:1194261164
Name:RACITI, HILARY A (RDN, CDN)
Entity type:Individual
Prefix:
First Name:HILARY
Middle Name:A
Last Name:RACITI
Suffix:
Gender:F
Credentials:RDN, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 NORTH AVE APT 21C
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-2419
Mailing Address - Country:US
Mailing Address - Phone:201-321-9436
Mailing Address - Fax:
Practice Address - Street 1:1211 HAMBURG TPKE
Practice Address - Street 2:SUITE 213
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-5043
Practice Address - Country:US
Practice Address - Phone:201-582-3492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-13
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008615-1133V00000X
NJ86035089133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered