Provider Demographics
NPI:1902831068
Name:BERTINUSON, CATHERINE J (RD LDN)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:J
Last Name:BERTINUSON
Suffix:
Gender:F
Credentials:RD LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 925
Mailing Address - Street 2:JEFFREY KORFF MD
Mailing Address - City:WILBRAHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01095-0925
Mailing Address - Country:US
Mailing Address - Phone:508-595-0531
Mailing Address - Fax:508-829-5367
Practice Address - Street 1:264 ELM STREET
Practice Address - Street 2:JEFFREY KORFF MD
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060
Practice Address - Country:US
Practice Address - Phone:413-585-0039
Practice Address - Fax:413-586-2148
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA170133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MALD0170OtherBLUE CROSS BLUE SHIELD
MAAA29800OtherHARVARD PILGRIM
MAAA29800OtherHARVARD PILGRIM