NPI 1003667072

Mariana Gandolfo Bustamante, MSRDNCD

Practitioner Registered Dietitian Madison, WI

Practice location

Address: 3209 Dryden Dr, Madison, WI 53704-3015
Phone: (608) 241-9020
Mailing address: 7974 Uw Health CT, Middleton, WI 53562-5531

Registered specialties

Registered Dietitian Primary

Dietary & Nutritional Service Providers Taxonomy 133V00000X Licence 5427-29 (WI)

Other Dietitian, Registered providers in Wisconsin →

Registry record

NPI: 1003667072
Entity type: Individual
Sex (as registered): Female
NPI issued: 28 Mar 2024
Record last updated: 22 Sep 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.