Provider Demographics
NPI:1396065496
Name:PIZZOFERRATO, DEIRDRE CRONIN (RD, CD-N)
Entity type:Individual
Prefix:MRS
First Name:DEIRDRE
Middle Name:CRONIN
Last Name:PIZZOFERRATO
Suffix:
Gender:F
Credentials:RD, CD-N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SAW MILL RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06073-2207
Mailing Address - Country:US
Mailing Address - Phone:860-633-2962
Mailing Address - Fax:
Practice Address - Street 1:1 SAW MILL RD
Practice Address - Street 2:
Practice Address - City:SOUTH GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06073-2207
Practice Address - Country:US
Practice Address - Phone:860-633-2962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000975133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered