Provider Demographics
NPI:1194547059
Name:MUSACCHIA, JULIA MARIE (MS,RDN,CDN,CNSC)
Entity type:Individual
Prefix:MS
First Name:JULIA
Middle Name:MARIE
Last Name:MUSACCHIA
Suffix:
Gender:F
Credentials:MS,RDN,CDN,CNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5444 LITTLE NECK PKWY APT 3G
Mailing Address - Street 2:
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11362-2216
Mailing Address - Country:US
Mailing Address - Phone:516-424-0973
Mailing Address - Fax:
Practice Address - Street 1:5444 LITTLE NECK PKWY APT 3G
Practice Address - Street 2:
Practice Address - City:LITTLE NECK
Practice Address - State:NY
Practice Address - Zip Code:11362-2216
Practice Address - Country:US
Practice Address - Phone:516-424-0973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY8610185133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered