Organization
SDC NUTRITION, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN DELLA CROCE MS, RD, CDN (PRESIDENT)
(917) 975-7946
Entity
Organization
Contact information
Practice address
405 RXR PLZ, UNIONDALE, NY 11556-3811
(800) 741-6638
(866) 610-7443
Mailing address
440 LAKEVIEW RD, BELLMORE, NY 11710-4209
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
006034
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100318993601
—
NY
01
—
9739196296
MEDICARE PACID
NY
Enumeration date
11/02/2010
Last updated
07/14/2023
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