Provider Demographics
NPI:1093213001
Name:SMALDONE, KRISTEN (MS, RD, CSP, CD-N)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:SMALDONE
Suffix:
Gender:F
Credentials:MS, RD, CSP, CD-N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 MILL PLAIN RD # 1007
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-5277
Mailing Address - Country:US
Mailing Address - Phone:203-444-7822
Mailing Address - Fax:
Practice Address - Street 1:4 WILLIAMS LN
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:CT
Practice Address - Zip Code:06470-1816
Practice Address - Country:US
Practice Address - Phone:203-444-7822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-24
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, PediatricGroup - Single Specialty