MEDICARE: DIET MATTERS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	000005	CT

General Provider Information

NPI Number	:	1114258720
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIET MATTERS, LLC

Provider Business Mailing Address
First Line	:	6 MIDBROOK LN
Second Line	:
City	:	OLD GREENWICH
State	:	CT
Zip	:	06870-1428
Country	:	US
Telephone Number	:	203-637-9163
Fax Number	:	203-637-9163

Provider Business Practice Location Address
First Line	:	6 MIDBROOK LN
Second Line	:
City	:	OLD GREENWICH
State	:	CT
Zip	:	06870-1428
Country	:	US
Telephone Number	:	203-637-9163
Fax Number	:	203-637-9163

Authorized Official
Title or Position	:	PRESIDENT / NUTRITIONAL THERAPIST
Name	:	MS. JEANNE SUSAN PICI
Credential	:	M.S., R.D., CD-N
Telephone Number	:	203-637-9163

Provider Enumeration Date	:	01/21/2010
Last Update Date	:	01/21/2010

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