Provider Demographics
NPI:1326546219
Name:RASSEKH, SHOREH (MS, RDN, CD/N)
Entity Type:Individual
Prefix:MRS
First Name:SHOREH
Middle Name:
Last Name:RASSEKH
Suffix:
Gender:F
Credentials:MS, RDN, CD/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 W RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117-2047
Mailing Address - Country:US
Mailing Address - Phone:860-236-1723
Mailing Address - Fax:
Practice Address - Street 1:53 W RIDGE DR
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06117-2047
Practice Address - Country:US
Practice Address - Phone:860-236-1723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-25
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered