Provider Demographics
NPI:1194930685
Name:RITOLI-LANG, ROMELY MAURA (RD)
Entity type:Individual
Prefix:MRS
First Name:ROMELY
Middle Name:MAURA
Last Name:RITOLI-LANG
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 DALE ST
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-1815
Mailing Address - Country:US
Mailing Address - Phone:860-233-3339
Mailing Address - Fax:
Practice Address - Street 1:10 DALE ST
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-1815
Practice Address - Country:US
Practice Address - Phone:860-233-3339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT873437133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT710000189Medicare PIN
CT710000189Medicare ID - Type Unspecified