Provider Demographics
NPI:1225481484
Name:BANCROFT, CASSIDY (RDN)
Entity Type:Individual
Prefix:MRS
First Name:CASSIDY
Middle Name:
Last Name:BANCROFT
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:CASSIDY
Other - Middle Name:
Other - Last Name:SCHMIDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:194 LITTLE MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-2023
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:125 LASALLE RD
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-2322
Practice Address - Country:US
Practice Address - Phone:860-906-1289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-22
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered