Provider Demographics
NPI:1821753229
Name:KATHERINE SAYRE NUTRITION
Entity Type:Organization
Organization Name:KATHERINE SAYRE NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAYRE
Authorized Official - Suffix:
Authorized Official - Credentials:MD, RD
Authorized Official - Phone:970-445-2779
Mailing Address - Street 1:3 BUNGALOW HILL RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-1702
Mailing Address - Country:US
Mailing Address - Phone:970-390-2892
Mailing Address - Fax:
Practice Address - Street 1:3 BUNGALOW HILL RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1702
Practice Address - Country:US
Practice Address - Phone:970-445-2779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, PediatricGroup - Single Specialty