Provider Demographics
NPI:1548458417
Name:PIERDIPINO, JOANN (RD)
Entity type:Individual
Prefix:MS
First Name:JOANN
Middle Name:
Last Name:PIERDIPINO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MS
Other - First Name:JOANN
Other - Middle Name:
Other - Last Name:PIERDIPINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD
Mailing Address - Street 1:6078 69TH PL
Mailing Address - Street 2:
Mailing Address - City:MASPETH
Mailing Address - State:NY
Mailing Address - Zip Code:11378-2942
Mailing Address - Country:US
Mailing Address - Phone:917-698-4371
Mailing Address - Fax:
Practice Address - Street 1:6078 69TH PL
Practice Address - Street 2:
Practice Address - City:MASPETH
Practice Address - State:NY
Practice Address - Zip Code:11378-2942
Practice Address - Country:US
Practice Address - Phone:917-698-4371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-04
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY850719133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered