Provider Demographics
NPI:1306676010
Name:DIMEGLIO, MARIE (RDN, LDN)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:DIMEGLIO
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CATALINA DR
Mailing Address - Street 2:
Mailing Address - City:ANSONIA
Mailing Address - State:CT
Mailing Address - Zip Code:06401-2514
Mailing Address - Country:US
Mailing Address - Phone:203-993-4612
Mailing Address - Fax:
Practice Address - Street 1:10 CATALINA DR
Practice Address - Street 2:
Practice Address - City:ANSONIA
Practice Address - State:CT
Practice Address - Zip Code:06401-2514
Practice Address - Country:US
Practice Address - Phone:203-993-4612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2236133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered