Provider Demographics
NPI:1003944901
Name:PALOTTA, MARTHA LEE (RD REGISTERED DIETIT)
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:LEE
Last Name:PALOTTA
Suffix:
Gender:F
Credentials:RD REGISTERED DIETIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5211 ESSEN LANE
Mailing Address - Street 2:SUITE 8A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809
Mailing Address - Country:US
Mailing Address - Phone:225-767-9009
Mailing Address - Fax:225-767-5100
Practice Address - Street 1:5211 ESSEN LANE
Practice Address - Street 2:SUITE 8A
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809
Practice Address - Country:US
Practice Address - Phone:225-767-9009
Practice Address - Fax:225-767-5100
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA634133N00000X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered133N00000XDietary & Nutritional Service ProvidersNutritionist
Not Answered133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
4C027Medicare ID - Type Unspecified