Provider Demographics
NPI:1285350967
Name:ANDREA'S NUTRITION CONSULTANT LLC
Entity type:Organization
Organization Name:ANDREA'S NUTRITION CONSULTANT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN/NUTRITIONIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:M
Authorized Official - Last Name:PLUNKETT
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, CDN
Authorized Official - Phone:203-919-1765
Mailing Address - Street 1:49 GLENDALE CIR
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06906-1213
Mailing Address - Country:US
Mailing Address - Phone:203-919-1765
Mailing Address - Fax:
Practice Address - Street 1:49 GLENDALE CIR
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06906-1213
Practice Address - Country:US
Practice Address - Phone:203-919-1765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty