Provider Demographics
NPI:1679989792
Name:KONSTANTIA E PAPAPATERAS
Entity Type:Organization
Organization Name:KONSTANTIA E PAPAPATERAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN NUTRITIONIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KONSTANTIA
Authorized Official - Middle Name:EVANGELIA
Authorized Official - Last Name:PAPAPATERAS
Authorized Official - Suffix:
Authorized Official - Credentials:RDN CDN
Authorized Official - Phone:860-284-0518
Mailing Address - Street 1:44 AVONWOOD RD
Mailing Address - Street 2:APT 212
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001-2047
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:345 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06117-2515
Practice Address - Country:US
Practice Address - Phone:860-278-3812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001247133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty