Individual provider Active NPI

Mary Jane Detroyer, M.S., R.D.

  • Registered Dietitian
  • New York, NY
National Provider Identifier
1346309978
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
004019-1 Issued in NY
Practice address
357 E 57TH St
Suite 14
New York, NY 10022-2907
Phone
(212) 759-7110
Fax
(212) 759-7113
NPI assigned
Dec 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 004019-1 NY Primary

Addresses

Primary practice location

357 E 57TH St
Suite 14
New York, NY 10022-2907

Mailing address

357 E 57TH St
Suite 14
New York, NY 10022-2907
Phone (212) 759-7110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346309978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "357 E 57TH ST",
            "address_2": "SUITE 14",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100222907",
            "telephone_number": "212-759-7110",
            "fax_number": "212-759-7113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "357 E 57TH ST",
            "address_2": "SUITE 14",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100222907",
            "telephone_number": "212-759-7110",
            "fax_number": "212-759-7113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETROYER",
        "first_name": "MARY JANE",
        "name_prefix": "Ms.",
        "credential": "M.S., R.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "004019-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.