Provider Demographics
NPI:1275238792
Name:TYRRELL, DANIELA SORENTINO (MS, CNS)
Entity Type:Individual
Prefix:MRS
First Name:DANIELA
Middle Name:SORENTINO
Last Name:TYRRELL
Suffix:
Gender:F
Credentials:MS, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 GREENWICH HILLS DR
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831-4966
Mailing Address - Country:US
Mailing Address - Phone:914-274-1424
Mailing Address - Fax:
Practice Address - Street 1:37 GREENWICH HILLS DR
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831-4966
Practice Address - Country:US
Practice Address - Phone:914-274-1424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist