Provider Demographics
NPI:1265519003
Name:TRIFILETTI, ELLEN MARY (RD LD CDE)
Entity type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:MARY
Last Name:TRIFILETTI
Suffix:
Gender:F
Credentials:RD LD CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2418 BOSTON ROAD
Mailing Address - Street 2:
Mailing Address - City:HINCKLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44233
Mailing Address - Country:US
Mailing Address - Phone:440-237-0726
Mailing Address - Fax:216-491-7463
Practice Address - Street 1:20000 HARVARD ROAD
Practice Address - Street 2:SOUTH POINT HOSPITAL DIABETES EDUCATION CENTER
Practice Address - City:WARRENSVILLE HTS
Practice Address - State:OH
Practice Address - Zip Code:44122-7099
Practice Address - Country:US
Practice Address - Phone:216-491-7434
Practice Address - Fax:216-491-7463
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHTRMT72021Medicare ID - Type Unspecified