Provider Demographics
NPI:1013952480
Name:NANCY DELL CANNATA
Entity Type:Organization
Organization Name:NANCY DELL CANNATA
Other - Org Name:NANCY DELL AND ASSOCIATES NUTRITION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:DELL-CANNATA
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:413-786-2957
Mailing Address - Street 1:PO BOX 789
Mailing Address - Street 2:
Mailing Address - City:LUDLOW
Mailing Address - State:MA
Mailing Address - Zip Code:01056-0789
Mailing Address - Country:US
Mailing Address - Phone:413-509-1000
Mailing Address - Fax:413-509-1003
Practice Address - Street 1:14 S WESTFIELD ST
Practice Address - Street 2:
Practice Address - City:FEEDING HILLS
Practice Address - State:MA
Practice Address - Zip Code:01030-2702
Practice Address - Country:US
Practice Address - Phone:413-786-2957
Practice Address - Fax:413-786-2956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA437133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MALG0004OtherBLUE CROSS/BLUE SHIELD
MAMT0539Medicare ID - Type Unspecified