Provider Demographics
NPI:1437512720
Name:BELLINO, COURTNEY (MS, RDN, LD)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:BELLINO
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 ISAAC LUCAS CIR
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-4913
Mailing Address - Country:US
Mailing Address - Phone:978-866-6290
Mailing Address - Fax:
Practice Address - Street 1:1 WASHINGTON ST STE 3121
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-2233
Practice Address - Country:US
Practice Address - Phone:978-866-6290
Practice Address - Fax:978-674-5482
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-04
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0968133V00000X
MA3850133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered