Provider Demographics
NPI:1316159809
Name:DAS, NALINI RITA (MA)
Entity type:Individual
Prefix:MR
First Name:NALINI
Middle Name:RITA
Last Name:DAS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2129 KENWOOD PL
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-3321
Mailing Address - Country:US
Mailing Address - Phone:516-785-8470
Mailing Address - Fax:516-781-2669
Practice Address - Street 1:102 BEDFORD AVE UNIT B
Practice Address - Street 2:
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-3576
Practice Address - Country:US
Practice Address - Phone:516-781-2669
Practice Address - Fax:516-781-6316
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILR356224133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06182002047701Medicare ID - Type UnspecifiedREGISTERED DIETITIAN