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General NPI Number Information
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NPI Number | 1336387406
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Entity Type | Individual
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Provider Name | CARA C ANDREOLI R.D., CDE
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Gender | Female
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Dates
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Enumeration Date | 01/28/2009
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Last Update Date | 05/04/2017
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Provider Practice Location Address
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Address Line | 99 CITIZENS DR
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City | GLASTONBURY
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State | CT
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Zip | 06033-1262
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Country | US
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Telephone | 860-888-6553
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Fax | 860-888-6553
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Provider Business Mailing Address
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Address Line | 41 MOCKINGBIRD LN
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City | GLASTONBURY
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State | CT
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Zip | 06033-1754
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Country | US
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Telephone | 860-888-6553
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Fax | 860-275-5529
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 000877
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License Number State | CT
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