Provider Demographics
NPI:1992301097
Name:NUTRITEAM LLC
Entity type:Organization
Organization Name:NUTRITEAM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER, REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:PUPUTTI
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RDN, LDN
Authorized Official - Phone:508-331-7444
Mailing Address - Street 1:1361 RINDGE RD
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-1323
Mailing Address - Country:US
Mailing Address - Phone:508-331-7444
Mailing Address - Fax:
Practice Address - Street 1:1361 RINDGE RD
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-1323
Practice Address - Country:US
Practice Address - Phone:978-516-4640
Practice Address - Fax:978-516-4650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-05
Last Update Date:2021-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty