Provider Demographics
NPI:1316324106
Name:PARCELLA, ELIZABETH A (RD, CSP, CDN)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:PARCELLA
Suffix:
Gender:F
Credentials:RD, CSP, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 HIGBY DR
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06450-3516
Mailing Address - Country:US
Mailing Address - Phone:203-440-9081
Mailing Address - Fax:
Practice Address - Street 1:225 HOPMEADOW ST
Practice Address - Street 2:
Practice Address - City:WEATOGUE
Practice Address - State:CT
Practice Address - Zip Code:06089-9782
Practice Address - Country:US
Practice Address - Phone:860-658-0465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-30
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT696133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered