Provider Demographics
NPI:1851606289
Name:ROSSELLI, CELESTE (BSN, LDN, CDE)
Entity type:Individual
Prefix:
First Name:CELESTE
Middle Name:
Last Name:ROSSELLI
Suffix:
Gender:F
Credentials:BSN, LDN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 NORTHAMPTON ST
Mailing Address - Street 2:SUITE 212
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-1908
Mailing Address - Country:US
Mailing Address - Phone:413-552-0899
Mailing Address - Fax:
Practice Address - Street 1:1850 NORTHAMPTON ST
Practice Address - Street 2:SUITE 212
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-1908
Practice Address - Country:US
Practice Address - Phone:413-552-0899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-10
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA249133NN1002X, 133V00000X
MARN230682163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No163W00000XNursing Service ProvidersRegistered Nurse