Provider Demographics
NPI:1487965851
Name:MCCOY, TRICIA LINETTE (RD)
Entity type:Individual
Prefix:MS
First Name:TRICIA
Middle Name:LINETTE
Last Name:MCCOY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 W 132ND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-7801
Mailing Address - Country:US
Mailing Address - Phone:617-680-8280
Mailing Address - Fax:
Practice Address - Street 1:109 W 132ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-7801
Practice Address - Country:US
Practice Address - Phone:617-680-8280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY982332133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered