Healthcare Provider Details

I. General information

NPI: 1134732365
Provider Name (Legal Business Name): CHELSEA COTUGNO MS RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2020
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 DUDLEY ST
PROVIDENCE RI
02905-3233
US

IV. Provider business mailing address

117 ELLENFIELD ST STE 101
PROVIDENCE RI
02905-4541
US

V. Phone/Fax

Practice location:
  • Phone: 401-453-7950
  • Fax: 401-453-7748
Mailing address:
  • Phone: 401-444-6779
  • Fax: 401-444-6912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLDN01415
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: