Individual
MS. LISA M MASTROIANNI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. R.D
Contact information
Practice address
20 YORK ST, NUTRITION CLINIC CBB 52, NEW HAVEN, CT 06510-3220
(203) 688-2422
(203) 688-2141
Mailing address
20 YORK ST, NUTRITION CLINIC CBB 52, NEW HAVEN, CT 06510-3220
(203) 688-2422
(203) 688-2141
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
000124
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C02658
YNHH MEDICARE NUMBER
CT
Enumeration date
12/04/2008
Last updated
12/04/2008
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