Provider Demographics
NPI:1003487927
Name:PUTNAM, NATALIYA (RD)
Entity Type:Individual
Prefix:MRS
First Name:NATALIYA
Middle Name:
Last Name:PUTNAM
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:NATALIYA
Other - Middle Name:
Other - Last Name:KOROSTENSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:8 PINE GLEN TER
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-2539
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:33 KNEELAND RD
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06512-5006
Practice Address - Country:US
Practice Address - Phone:781-315-9185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-02
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered