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NPI Code Detail

MEDICARE: NAUTICAL NUTRITION SERVICES LLC

MEDICARE: NAUTICAL NUTRITION SERVICES 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
1133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1568108694
Entity Type Code : Organization
Provider Name (Legal Business Name) : NAUTICAL NUTRITION SERVICES LLC
Provider Business Mailing Address
First Line : 66 FRANKLIN ST
Second Line :
City : NORWICH
State : CT
Zip : 06360-5806
Country : US
Telephone Number : 860-934-4926
Fax Number :
Provider Business Practice Location Address
First Line : 66 FRANKLIN ST
Second Line :
City : NORWICH
State : CT
Zip : 06360-5806
Country : US
Telephone Number : 860-934-4926
Fax Number : 866-823-8168
Authorized Official
Title or Position : OWNER/ ORGANIZER
Name : SERENA BIONDI
Credential : RD
Telephone Number : 860-381-9619
Provider Enumeration Date : 05/11/2022
Last Update Date : 02/14/2023

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Directions to “NAUTICAL NUTRITION SERVICES LLC ” Practice Location

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