Provider Demographics
NPI:1215639364
Name:WILMOT-REGO, ASHLYN RAIN (MS, RDN)
Entity type:Individual
Prefix:
First Name:ASHLYN
Middle Name:RAIN
Last Name:WILMOT-REGO
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 MONTROSE AVE APT 1R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-2832
Mailing Address - Country:US
Mailing Address - Phone:508-828-8179
Mailing Address - Fax:
Practice Address - Street 1:385 SENECA AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-1340
Practice Address - Country:US
Practice Address - Phone:718-366-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered