Provider Demographics
NPI:1285117077
Name:COLUZZI, MICHELLE (MPHIL, MS, RDN)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:COLUZZI
Suffix:
Gender:F
Credentials:MPHIL, MS, RDN
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:LANDSTROM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPHIL, MS, RDN
Mailing Address - Street 1:50 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NY
Mailing Address - Zip Code:13346-1326
Mailing Address - Country:US
Mailing Address - Phone:781-392-6204
Mailing Address - Fax:
Practice Address - Street 1:50 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NY
Practice Address - Zip Code:13346-1326
Practice Address - Country:US
Practice Address - Phone:781-392-6204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-08
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered