Provider Demographics
NPI:1104564327
Name:THE EUSANIO GROUP, LLC
Entity type:Organization
Organization Name:THE EUSANIO GROUP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:EUSANIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-608-5808
Mailing Address - Street 1:5903 MOUNT EAGLE DR APT 1409
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22303-2532
Mailing Address - Country:US
Mailing Address - Phone:703-608-5808
Mailing Address - Fax:703-263-8650
Practice Address - Street 1:5680 KING CENTRE DR STE 600
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22315-5755
Practice Address - Country:US
Practice Address - Phone:703-608-5808
Practice Address - Fax:703-263-8650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-26
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight ManagementGroup - Single Specialty