Provider Demographics
NPI:1366815474
Name:APICELLA, ANTONELLA (MS RD CDN)
Entity type:Individual
Prefix:
First Name:ANTONELLA
Middle Name:
Last Name:APICELLA
Suffix:
Gender:F
Credentials:MS RD CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 WILLIS AVE
Mailing Address - Street 2:UNIT 3D
Mailing Address - City:WILLISTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11596-1150
Mailing Address - Country:US
Mailing Address - Phone:516-318-0215
Mailing Address - Fax:
Practice Address - Street 1:711 WILLIS AVE
Practice Address - Street 2:UNIT 3D
Practice Address - City:WILLISTON PARK
Practice Address - State:NY
Practice Address - Zip Code:11596-1150
Practice Address - Country:US
Practice Address - Phone:516-318-0215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-11
Last Update Date:2015-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007044133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered