Active NPI
Lenore Odessa Mangaser, R.D.
- Registered Dietitian
- Jersey City, NJ
National Provider Identifier
1942576491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 007003-1
- Practice address
- 280 Marin Blvd Apt 21F
Jersey City, NJ 07302-3689 - Phone
- (646) 265-1162
- NPI assigned
- Mar 29, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 007003-1 | NY | Primary |
Addresses
Primary practice location
280 Marin Blvd Apt 21F
Jersey City, NJ 07302-3689
Mailing address
PO Box 13642
Philadelphia, PA 19101-3642
Other practice location 1
121 Dekalb Ave Fl 2
Brooklyn, NY 11201-5425
Phone (182) 508-9207
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 |
|---|---|---|---|
| 007003-1 | NY | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724198400000",
"number": "1942576491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 13642",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191013642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "280 MARIN BLVD APT 21F",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073023689",
"telephone_number": "646-265-1162"
}
],
"practiceLocations": [
{
"address_1": "121 Dekalb Ave Fl 2",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "112015425",
"country_code": "US",
"telephone_number": "182-508-9207",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MANGASER",
"first_name": "LENORE",
"middle_name": "ODESSA",
"name_prefix": "Miss",
"credential": "R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-29",
"last_updated": "2024-08-21",
"certification_date": "2024-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "007003-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jersey City, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.