Organization
AMY D'ANGELO NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY P DANGELO RD (OWNER)
(978) 895-0913
Entity
Organization
Contact information
Practice address
135 CHRISTIAN LN, SOUTH DEERFIELD, MA 01373-9646
(978) 895-0913
Mailing address
135 CHRISTIAN LN, SOUTH DEERFIELD, MA 01373-9646
(978) 895-0913
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2179
STATE
SC
01
—
4942-NU-NU
STATE
MA
01
—
74.0134235
STATE
VT
01
—
8605310
CDR
—
01
—
86944
STATE
TX
01
—
L004920
STATE
NC
01
—
LD1424
STATE
NM
Enumeration date
07/15/2021
Last updated
07/15/2021
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