Provider Demographics
NPI:1891712238
Name:SCHWARTZ, JULIE (RD, LD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:NEW CANAAN
Mailing Address - State:CT
Mailing Address - Zip Code:06840-5325
Mailing Address - Country:US
Mailing Address - Phone:844-359-8363
Mailing Address - Fax:
Practice Address - Street 1:69 GROVE ST
Practice Address - Street 2:
Practice Address - City:NEW CANAAN
Practice Address - State:CT
Practice Address - Zip Code:06840-5325
Practice Address - Country:US
Practice Address - Phone:844-359-8363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2247133VN1201X
DEDN-0010974133VN1201X
NCL006677133VN1201X
GALD001484133V00000X
MDDX5486133VN1201X
OHLD.09511133VN1201X
IL164.008665133VN1201X
FLND10529133VN1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA392434510AMedicaid
GA392434510AMedicaid
GAQ41017001Medicare UPIN