Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Marissa A. Licata, RD

Individual provider Registered Dietitian · NPI 1134180169

Marissa A. Licata, RD is a Registered Dietitian OR Nutrition Professional in New Hyde Park, New York. Qualified in 2009, 17 years ago. Practices with North Shore-Lij Medical PC, a 6,350-clinician group and accepts Medicare assignment.

Years since qualifying
17
In the registry since
2006
What do these letters mean?
RD — Registered Dietitian
A credentialed nutrition professional.

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Practice location Address checks out

270-05 76th Ave Ste 103
New Hyde Park, NY 11040
Phone: (516) 881-7060
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence 877337

Record details

NPI number1134180169
Entity typeIndividual (Type 1)
GenderFemale
Credentials RD
Sole proprietorNo
NPI enumeratedMarch 29, 2006
Last updated in NPPESJuly 27, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyREGISTERED DIETITIAN OR NUTRITION PROFESSIONAL
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice North Shore-Lij Medical Pc — 6350 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in New Hyde Park