Provider Demographics
NPI:1780864173
Name:VIJ, RENU (MS, RD, CDN)
Entity Type:Individual
Prefix:MRS
First Name:RENU
Middle Name:
Last Name:VIJ
Suffix:
Gender:F
Credentials:MS, RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 TECHNOLOGY DR
Mailing Address - Street 2:STE B-106
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-6337
Mailing Address - Country:US
Mailing Address - Phone:203-692-2180
Mailing Address - Fax:203-452-1412
Practice Address - Street 1:115 TECHNOLOGY DR
Practice Address - Street 2:STE B-106
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-6337
Practice Address - Country:US
Practice Address - Phone:203-692-2180
Practice Address - Fax:203-452-1412
Is Sole Proprietor?:No
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000380133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic