Provider Demographics
NPI:1467278333
Name:FIDEL, MEREDITH I (RDN)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:I
Last Name:FIDEL
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 COMPO RD S
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-6022
Mailing Address - Country:US
Mailing Address - Phone:917-848-7454
Mailing Address - Fax:
Practice Address - Street 1:222 COMPO RD S
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-6022
Practice Address - Country:US
Practice Address - Phone:917-848-7454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered