Provider Demographics
NPI:1063684785
Name:MULLER, LORI H (RD LD CDE)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:H
Last Name:MULLER
Suffix:
Gender:F
Credentials:RD LD CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BUTTRICK RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3417
Mailing Address - Country:US
Mailing Address - Phone:603-537-1300
Mailing Address - Fax:603-537-1326
Practice Address - Street 1:6 TSIENNETO RD
Practice Address - Street 2:SUITE 100
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-1584
Practice Address - Country:US
Practice Address - Phone:603-537-1300
Practice Address - Fax:603-537-1326
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY709712133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHMU-MT0811Medicare PIN