Healthcare Provider Details

I. General information

NPI: 1689442295
Provider Name (Legal Business Name): MADELEINE PUTZI MS, RDN, CLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2023
Last Update Date: 12/13/2023
Certification Date: 12/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 SHADOW DR
PITTSBURGH PA
15227-1049
US

IV. Provider business mailing address

2121 NOBLESTOWN RD STE 210
PITTSBURGH PA
15205-3956
US

V. Phone/Fax

Practice location:
  • Phone: 570-470-4863
  • Fax:
Mailing address:
  • Phone: 412-350-4637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: