Maryrose Ammirati, RD, CDN, CLC
Individual provider Active NPI Registered Dietitian · Farmingdale, NY
NPI 1891247607 · NPPES record last updated Dec 10, 2024
Key facts
- NPI
- 1891247607
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 007859-1 (NY)
- Practice address
- 2 Dubon CT
Farmingdale, NY 11735-1031 - Phone
- (631) 210-6362
- NPI assigned
- Oct 27, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 321986 | NY | MD | Lactation Consultant (Non-RN) |
| 007859-1 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lilac Nutrition LLC | Dietitian, Registered | Current |
Accepting new patients |
Locations
2 Dubon Ct
Farmingdale, NY 11735
Phone (516) 830-0765
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lactation Consultant (Non-RN) | 174N00000X | 321986 | NY | |
| Registered Dietitian | 133V00000X | 007859-1 | NY | Yes |
Addresses
Primary practice location
2 Dubon CT
Farmingdale, NY 11735-1031
Mailing address
712 Oak Neck Road
West Islip, NY 11795
Phone (631) 987-8915
Other practice location 1
712 Oak Neck Road
West Islip, NY 11795
Phone (631) 210-6362
Other providers in Farmingdale, NY
- Brian Alvarez
- Sadira Ann Alvarez
- Carmen Alvelo
- Mildred Amarteifio
- Amira Bekhit
- Kia Ann Ammonds
- Sean Anderson
- Maria Estefania Angamarca Cordova
- James Joseph Angst
- Antonio Carratelli Licensed Marital and Family Therapist PC
All providers in Farmingdale, NY · Registered Dietitian in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.