Provider Demographics
NPI:1982849287
Name:KOBLINER, VICTORIA ROUSSO (RD)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:ROUSSO
Last Name:KOBLINER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 DANBURY RD
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-4437
Mailing Address - Country:US
Mailing Address - Phone:203-834-9949
Mailing Address - Fax:203-834-9938
Practice Address - Street 1:150 DANBURY RD
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-4437
Practice Address - Country:US
Practice Address - Phone:203-834-9949
Practice Address - Fax:203-834-9938
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-16
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000354133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered