Organization
BORDEAUX NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RENEE J BORDEAUX RD, CDN, CPT (OWNER)
(860) 978-9449
Entity
Organization
Contact information
Practice address
66 CEDAR ST, 305, NEWINGTON, CT 06111-2633
(860) 523-0141
(860) 523-0141
Mailing address
66 CEDAR ST, SUITE 305, NEWINGTON, CT 06111-2633
(860) 523-0141
(860) 523-0141
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
000472
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3199218
UNITED HEALTHCARE
CT
01
—
695189
CONNECTICARE INC.
CT
01
—
7982509
AETNA
CT
01
—
P3946637
OXFORD
CT
Enumeration date
12/01/2015
Last updated
12/04/2015
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