Provider Demographics
NPI:1073177085
Name:RONDINONE, SARAH LYN (MS, RDN, CDN)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:LYN
Last Name:RONDINONE
Suffix:
Gender:F
Credentials:MS, RDN, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 W ISLAND BEACH RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:CT
Mailing Address - Zip Code:06249-2212
Mailing Address - Country:US
Mailing Address - Phone:860-303-0933
Mailing Address - Fax:
Practice Address - Street 1:15 W ISLAND BEACH RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:CT
Practice Address - Zip Code:06249-2212
Practice Address - Country:US
Practice Address - Phone:860-303-0933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT86062444133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered