Provider Demographics
NPI:1023486578
Name:PONTES, ANAMARIA (MS, RD, CDN)
Entity type:Individual
Prefix:MS
First Name:ANAMARIA
Middle Name:
Last Name:PONTES
Suffix:
Gender:F
Credentials:MS, RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 E 101ST ST
Mailing Address - Street 2:SUITE NUMBER 7
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6128
Mailing Address - Country:US
Mailing Address - Phone:917-215-5439
Mailing Address - Fax:
Practice Address - Street 1:248 E 73RD ST
Practice Address - Street 2:SUITE NUMER 4
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4303
Practice Address - Country:US
Practice Address - Phone:212-744-9949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-14
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008073-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered