Provider Demographics
NPI:1013297662
Name:NEWTRITION SPOT, LLC.
Entity Type:Organization
Organization Name:NEWTRITION SPOT, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:PERACCHIO
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, CD-N
Authorized Official - Phone:203-980-5616
Mailing Address - Street 1:558 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-2100
Mailing Address - Country:US
Mailing Address - Phone:203-980-5616
Mailing Address - Fax:
Practice Address - Street 1:558 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-2100
Practice Address - Country:US
Practice Address - Phone:203-980-5616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000958133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty