Provider Demographics
NPI:1689349086
Name:ALIBRIO, MARLA BARONCINI (RD)
Entity Type:Individual
Prefix:MRS
First Name:MARLA
Middle Name:BARONCINI
Last Name:ALIBRIO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 SOUTHPOND RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06073-2326
Mailing Address - Country:US
Mailing Address - Phone:860-559-1419
Mailing Address - Fax:
Practice Address - Street 1:51 SOUTHPOND RD
Practice Address - Street 2:
Practice Address - City:SOUTH GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06073-2326
Practice Address - Country:US
Practice Address - Phone:860-559-1419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT861586133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered