Individual
DEBRA PENASSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
200 LAKE ST, NEWBURGH, NY 12550-5243
(845) 565-8022
(845) 565-6349
Mailing address
2 COATES DR, GOSHEN, NY 10924-6758
(845) 651-1412
(845) 651-1512
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
862415
DIETETIC REGISTRATION
—
Enumeration date
12/12/2012
Last updated
12/12/2012
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