Active NPI
Dominique Noel Pacitti, RDN, LDN, IBCLC
- Registered Dietitian
- Gwynedd Valley, PA
National Provider Identifier
1376001099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DN006772
- Practice address
- 1618 Kings Mill Rd
Gwynedd Valley, PA 19437 - Phone
- (215) 360-4801
- NPI assigned
- Mar 12, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lactation Consultant (Non-RN) | 174N00000X | L-302209 | PA | |
| Registered Dietitian | 133V00000X | DN006772 | PA | Primary |
Addresses
Primary practice location
1618 Kings Mill Rd
Gwynedd Valley, PA 19437
Mailing address
PO Box 353
Gwynedd Valley, PA 19437-0353
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN006772 | PA | MD | Registered Dietitian |
| L-302209 | PA | MD | Lactation Consultant (Non-RN) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611273600000",
"number": "1376001099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 353",
"city": "GWYNEDD VALLEY",
"state": "PA",
"postal_code": "194370353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1618 KINGS MILL RD",
"city": "GWYNEDD VALLEY",
"state": "PA",
"postal_code": "19437",
"telephone_number": "215-360-4801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACITTI",
"first_name": "DOMINIQUE",
"middle_name": "NOEL",
"credential": "RDN, LDN, IBCLC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-03-12",
"last_updated": "2021-01-22",
"certification_date": "2021-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "174N00000X",
"taxonomy_group": "",
"desc": "Lactation Consultant, Non-RN",
"state": "PA",
"license": "L-302209",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "DN006772",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gwynedd Valley, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.