Provider Demographics
NPI:1396324026
Name:ABOTT, DALIA (LMSW, RD, CDN)
Entity type:Individual
Prefix:
First Name:DALIA
Middle Name:
Last Name:ABOTT
Suffix:
Gender:F
Credentials:LMSW, RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 FELTER AVE
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1106
Mailing Address - Country:US
Mailing Address - Phone:718-490-9232
Mailing Address - Fax:
Practice Address - Street 1:319 FELTER AVE
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1106
Practice Address - Country:US
Practice Address - Phone:718-490-9232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY062189104100000X
NY857582133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No104100000XBehavioral Health & Social Service ProvidersSocial Worker