Provider Demographics
NPI:1447536255
Name:STASENKO, NATALIA (MS, RD)
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:STASENKO
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 N END AVE
Mailing Address - Street 2:16P
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10282-1026
Mailing Address - Country:US
Mailing Address - Phone:917-543-0680
Mailing Address - Fax:
Practice Address - Street 1:325 N END AVE
Practice Address - Street 2:16P
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10282-1026
Practice Address - Country:US
Practice Address - Phone:917-543-0680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-25
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered