Individual
MRS. JENNIFER ANNE DEPAOLO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
R.D., C.D.E.
Contact information
Practice address
119 W 57TH ST, SUITE 1414, NEW YORK, NY 10019-2303
(212) 333-4243
Mailing address
145 HICKS ST, BROOKLYN, NY 11201-2321
(917) 447-6135
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
005504-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005504
HIP PROV #
NY
01
—
10765267
HIP PIN#
NY
01
—
116230P
HIP PRIS#
NY
01
—
1G1071
BLUECROSS
NY
01
—
2281535
UNITED
NY
01
—
3096578
USHC
NY
01
—
3C6153
HEALTHNET
NY
01
—
7762747003
CIGNA
NY
01
—
7791422
AETNA
NY
01
—
8099852
GHI
NY
01
—
DJ5504
ATLANTIS
NY
01
—
P2793985
OXFORD
NY
Enumeration date
05/05/2006
Last updated
07/08/2007
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