Provider Demographics
NPI:1619390432
Name:CAVALERI, LINDA LEOCADIA (RD, CD-N)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:LEOCADIA
Last Name:CAVALERI
Suffix:
Gender:F
Credentials:RD, CD-N
Other - Prefix:MISS
Other - First Name:LINDA
Other - Middle Name:LEOCADIA
Other - Last Name:RETALLACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:745 MERROW ROAD
Mailing Address - Street 2:SUITE #169
Mailing Address - City:COVENTRY
Mailing Address - State:CT
Mailing Address - Zip Code:06238-1372
Mailing Address - Country:US
Mailing Address - Phone:860-742-1464
Mailing Address - Fax:860-742-1464
Practice Address - Street 1:745 MERROW ROAD
Practice Address - Street 2:SUITE #169
Practice Address - City:COVENTRY
Practice Address - State:CT
Practice Address - Zip Code:06238-1372
Practice Address - Country:US
Practice Address - Phone:860-742-1464
Practice Address - Fax:860-742-1464
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
706240133N00000X
CT000415133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education