Provider Demographics
NPI:1336387406
Name:ANDREOLI, CARA C (RD, CDE)
Entity Type:Individual
Prefix:MS
First Name:CARA
Middle Name:C
Last Name:ANDREOLI
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 MOCKINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-1754
Mailing Address - Country:US
Mailing Address - Phone:860-888-6553
Mailing Address - Fax:860-275-5529
Practice Address - Street 1:99 CITIZENS DR
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-1262
Practice Address - Country:US
Practice Address - Phone:860-888-6553
Practice Address - Fax:860-888-6553
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-28
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000877133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered