Provider Demographics
NPI:1518325752
Name:TRIPODI, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:TRIPODI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1071 POST RD E
Mailing Address - Street 2:SUITE 203
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-5364
Mailing Address - Country:US
Mailing Address - Phone:203-515-6311
Mailing Address - Fax:
Practice Address - Street 1:1071 POST RD E
Practice Address - Street 2:SUITE 203
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-5364
Practice Address - Country:US
Practice Address - Phone:203-515-6311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT871091133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered