Provider Demographics
NPI:1609648666
Name:DIMEO, ELIZABETH ANGELA (MS CNS LDN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANGELA
Last Name:DIMEO
Suffix:
Gender:F
Credentials:MS CNS LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 HIGHCROFT PL
Mailing Address - Street 2:
Mailing Address - City:WEATOGUE
Mailing Address - State:CT
Mailing Address - Zip Code:06089-7917
Mailing Address - Country:US
Mailing Address - Phone:860-491-4746
Mailing Address - Fax:
Practice Address - Street 1:613 HIGHCROFT PL
Practice Address - Street 2:
Practice Address - City:WEATOGUE
Practice Address - State:CT
Practice Address - Zip Code:06089-7917
Practice Address - Country:US
Practice Address - Phone:860-491-4746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000792133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education