Jane Prokopowicz, MBA MS RD CDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

563893 Issued in NY

Practice address

29 Polo Rd
Massapequa, NY 11758-5937

Phone

(516) 798-2934

NPI assigned

Feb 25, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Business Administration, Master of Science

State licenses

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

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317600000000",
    "number": "1952541385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 POLO ROAD",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "11758",
            "telephone_number": "516-798-2934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 POLO RD",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585937",
            "telephone_number": "516-798-2934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROKOPOWICZ",
        "first_name": "JANE",
        "credential": "MBA MS RD CDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-25",
        "last_updated": "2011-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "563893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Massapequa, NY
• Providers in Massapequa, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2011; 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.