Provider Demographics
NPI:1699331827
Name:RDNCONNECT LLC
Entity type:Organization
Organization Name:RDNCONNECT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ANZO
Authorized Official - Suffix:
Authorized Official - Credentials:MS,RDN,LD, CDCES
Authorized Official - Phone:330-635-4639
Mailing Address - Street 1:3095 TRENTWOOD CT
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-4292
Mailing Address - Country:US
Mailing Address - Phone:330-801-4538
Mailing Address - Fax:
Practice Address - Street 1:3095 TRENTWOOD CT
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:OH
Practice Address - Zip Code:44212-4292
Practice Address - Country:US
Practice Address - Phone:330-801-4538
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-13
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, RenalGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty