Provider Demographics
NPI:1922619618
Name:RAPONE, AMY L (MS, RD, CDN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:RAPONE
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 1:67 OLD POST RD
Mailing Address - Street 2:
Mailing Address - City:TOLLAND
Mailing Address - State:CT
Mailing Address - Zip Code:06084-3342
Mailing Address - Country:US
Mailing Address - Phone:203-806-0840
Mailing Address - Fax:
Practice Address - Street 1:67 OLD POST RD
Practice Address - Street 2:
Practice Address - City:TOLLAND
Practice Address - State:CT
Practice Address - Zip Code:06084-3342
Practice Address - Country:US
Practice Address - Phone:203-806-0840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-14
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001267133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered