Stefanie Sacks Dec, M.S., C.N.S, C.D.N

Primary specialty

Nutrition Education NutritionistTaxonomy code 133NN1002X

License

007511 Issued in NY

Practice address

17 N Farragut Rd
Montauk, NY 11954-5088

Phone

(917) 686-3778

NPI assigned

Jun 7, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Specialist, Master of Science

State licenses

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465257600000",
    "number": "1356790760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 N FARRAGUT RD",
            "city": "MONTAUK",
            "state": "NY",
            "postal_code": "119545088",
            "telephone_number": "917-686-3778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 N FARRAGUT RD",
            "city": "MONTAUK",
            "state": "NY",
            "postal_code": "119545088",
            "telephone_number": "917-686-3778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACKS DEC",
        "first_name": "STEFANIE",
        "credential": "M.S., C.N.S, C.D.N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-07",
        "last_updated": "2016-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NY",
            "license": "007511",
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "NY",
            "license": "007511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nutrition Education Nutritionist in Montauk, NY
• Providers in Montauk, NY by specialty
• Nutrition Education Nutritionist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; 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.