Provider Demographics
NPI:1417399569
Name:VERDI, HEIDI K (MS, RD, CD-N)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:K
Last Name:VERDI
Suffix:
Gender:F
Credentials:MS, RD, CD-N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BRADLEY LN
Mailing Address - Street 2:
Mailing Address - City:SANDY HOOK
Mailing Address - State:CT
Mailing Address - Zip Code:06482-1644
Mailing Address - Country:US
Mailing Address - Phone:203-304-8174
Mailing Address - Fax:
Practice Address - Street 1:7 BRADLEY LN
Practice Address - Street 2:
Practice Address - City:SANDY HOOK
Practice Address - State:CT
Practice Address - Zip Code:06482-1644
Practice Address - Country:US
Practice Address - Phone:203-304-8174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT00183133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered