MARISSA A. LICATA (NPI# 1134180169) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134180169 |
| Entity Type | Individual |
| Full Name | MARISSA A. LICATA |
| Credential | RD |
| Practice Address |
270-05 76th Avenue Suite 103 New Hyde Park NY 11040 |
| Mailing Address |
7 Hastings Dr Merrick NY 11566-1442 |
| Practice Telephone | 5168817060 |
| Mailing Telephone | 2123469161 |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2016-07-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 877337 | Dietary & Nutritional Service Providers |
| Street Address |
270-05 76TH AVENUE SUITE 103 |
| City | NEW HYDE PARK |
| State | NY |
| Zip Code | 11040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427054659 | Craig Merola | Anesthesiology | 270-05 76th Avenue, Department of Anesthesia, New Hyde Park, NY 11040 | 2005-06-22 |
| 1124648530 | Ellen Pham | Student in an Organized Health Care Education/Training Program | 270-05 76th Avenue, Research Building C Level Room 039ab N, New Hyde Park, NY 11040 | 2020-04-26 |
| 1922637669 | Jasmin Neal | Student in an Organized Health Care Education/Training Program | 270-05 76th Avenue, Research Bldg, C Level Room 039ab, New Hyde Park, NY 11040 | 2020-04-04 |
| 1346803236 | Remi Minh Khang Le | Student in an Organized Health Care Education/Training Program | 270-05 76th Avenue, New Hyde Park, NY 11040 | 2019-04-17 |
| 1003378852 | Oliver Standring | Student in an Organized Health Care Education/Training Program | 270-05 76th Avenue, Victoria Wrathe, Research Building- C Level Room 039ab, New Hyde Park, NY 11040 | 2019-04-02 |
| 1306320080 | Tanya J Thakur | Physician Assistant | 270-05 76th Avenue, New Hyde Park, NY 11040 | 2018-09-19 |
| 1023513231 | Michael Quinn | Student in an Organized Health Care Education/Training Program | 270-05 76th Avenue, New Hyde Park, NY 11040 | 2018-03-28 |
| 1407350796 | Kristen Zaffuto | Registered Nurse | 270-05 76th Avenue, Oncology Building, New Hyde Park, NY 11040-1402 | 2018-03-21 |
| 1063950384 | Kason Wan | Physician Assistant | 270-05 76th Avenue, New Hyde Park, NY 11040-1402 | 2017-02-07 |
| 1275920720 | Jeffrey Deygoo | Student in an Organized Health Care Education/Training Program | 270-05 76th Avenue, New Hyde Park, NY 11040 | 2015-04-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598366734 | Naurin Shaki | Case Management | 108 Bryant Ave, New Hyde Park, NY 11040 | 2020-11-04 |
| 1326645920 | Oksana Isakharov | Marriage & Family Therapist | Remote Telehealth Due To Pandemic, Remote Telehealth Due To Pandemic, NY 11040 | 2020-10-06 |
| 1639784036 | Michelle Edith Narain | Nurse Practitioner | 270-05 76th Aveune, New Hyde Park, NY 11040 | 2020-09-11 |
| 1124636188 | Shannon Maureen O'connell | Physician Assistant | 270-05 270th Ave, New Hyde Park, NY 11040 | 2020-07-16 |
| 1851929384 | Hollie Brown | Student in an Organized Health Care Education/Training Program | 45 Lakeville Rd Ste M41, New Hyde Park, NY 11040 | 2020-03-30 |
| 1780211797 | Miriam Tarrash | Student in an Organized Health Care Education/Training Program | Lijmc, 270-05 76th Avenue, New Hyde Park, NY 11040 | 2020-03-27 |
| 1902438971 | Kristina Petrich | Student in an Organized Health Care Education/Training Program | Long Island Jewish Medical Center, 270-05 76th Avenue, New Hyde Park, NY 11040 | 2020-02-07 |
| 1528622735 | David Olatunji Omole | Dentist | 270-05 76th Avenue Dept. of Dental Medicine / Oral And, Surgery New Hyde Park, Ny, Ny 11040, New Hyde Park, NY 11040 | 2019-04-24 |
| 1720642093 | Thanzina Chowdhury | Pharmacy | 271-11 76th Ave, Queens, NY 11040 | 2019-04-23 |
| 1427519834 | Connor William Crowley | Student in an Organized Health Care Education/Training Program | Office of Surgical Education Victoria M. Waithe, 270-05 76th Avenue. Research Bldg - C Level Room 039ab, New Hyde Park, NY 11040 | 2019-03-28 |
| Find all providers in zip 11040 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922549443 | Kristina Ng | Dietitian, Registered | 2001 Marcus Ave Ste W260, New Hyde Park, NY 11042-1071 | 2017-03-16 |
| 1669919478 | Nicole O'brien | Dietitian, Registered | 1574 Hillside Avenue, New Hyde Park, NY 11040 | 2017-01-31 |
| 1598200958 | Nirmala Golder | Dietitian, Registered | 24 Lawrence St, New Hyde Park, NY 11040-1721 | 2016-12-21 |
| 1336533082 | Emily Anschlowar | Dietitian, Registered | 21 Nugent Street, New Hyde Park, NY 11040 | 2015-03-20 |
| 1689904526 | Lourdes Rodriguez-eisenberg | Dietitian, Registered | 165 Celler Ave, New Hyde Park, NY 11040-2058 | 2009-12-27 |
| 1861667750 | Denise Koke | Dietitian, Registered | 1979 Marcus Ave Ste 2004, Global Communication Service, New Hyde Park, NY 11042-1002 | 2008-04-23 |
| 1043432990 | Sotiria Everett | Dietitian, Registered | 1981 Marcus Ave Ste E110, North Shore-lij Health System, New Hyde Park, NY 11042-1038 | 2007-05-02 |
| 1144249616 | Adrienne Katz | Dietitian, Registered | 11 Kemp Ln, New Hyde Park, NY 11040-3618 | 2006-07-18 |
| 1386257558 | Elizabeth Villanyi | Dietitian, Registered | 3000 Marcus Ave Ste 2w15, New Hyde Park, NY 11042-1005 | 2020-08-27 |
| 1407491772 | Kimberly Andreacchio | Dietitian, Registered | 1991 Marcus Ave, New Hyde Park, NY 11042-2057 | 2019-11-11 |
| Find all providers in NEW HYDE PARK | ||||
| City | NEW HYDE PARK |
| Zip Code | 11040 |
Please comment or provide details below to improve the information on MARISSA A. LICATA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.