Provider Demographics
NPI:1487876785
Name:VINAS, ERICA A (RD, CDE)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:A
Last Name:VINAS
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3736 HENRY HUDSON PKWY
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1502
Mailing Address - Country:US
Mailing Address - Phone:718-549-6268
Mailing Address - Fax:718-549-7178
Practice Address - Street 1:3736 HENRY HUDSON PKWY
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-1502
Practice Address - Country:US
Practice Address - Phone:718-549-6268
Practice Address - Fax:718-549-7178
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000690133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered