MEDICARE: PAULA MEYER RD MS

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	000836	CT

General Provider Information

NPI Number	:	1407384589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULA MEYER RD MS

Provider Business Mailing Address
First Line	:	PO BOX 2629
Second Line	:
City	:	WESTPORT
State	:	CT
Zip	:	06880-0629
Country	:	US
Telephone Number	:	203-216-2641
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 BAY ST STE 2C
Second Line	:
City	:	WESTPORT
State	:	CT
Zip	:	06880-4324
Country	:	US
Telephone Number	:	203-216-2641
Fax Number	:	203-557-0572

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2017
Last Update Date	:	06/01/2017

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