Provider Demographics
NPI:1548861826
Name:CANDITO, NORAH (MS, RDN)
Entity type:Individual
Prefix:
First Name:NORAH
Middle Name:
Last Name:CANDITO
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 1:2228 LATONA ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-4219
Mailing Address - Country:US
Mailing Address - Phone:570-352-2948
Mailing Address - Fax:
Practice Address - Street 1:1100 JEFFERSON ST APT 307
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-2379
Practice Address - Country:US
Practice Address - Phone:570-352-2948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-04
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ86077227133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
86077227OtherCOMMISSION ON DIETETIC REGISTRATION