NPI 1811474612

Mariela Perez Russo, MDCNS

Practitioner Nutritionist Trumbull, CT

Practice location

Address: 290 Booth Hill Rd, Trumbull, CT 06611-4943
Phone: (646) 255-9510

Registered specialties (2)

Nutritionist Primary

Dietary & Nutritional Service Providers Taxonomy 133N00000X

Other Nutritionist providers in Connecticut →

Nutritionist

Dietary & Nutritional Service Providers Taxonomy 133N00000X Licence 1644 (CT)

Registry record

NPI: 1811474612
Entity type: Individual
Sex (as registered): Female
NPI issued: 24 Jul 2018
Record last updated: 24 Jul 2018

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.