Provider Demographics
NPI:1457567588
Name:KNYSZEWSKA-DZIUDA, DOROTA (MS, CNS)
Entity Type:Individual
Prefix:MS
First Name:DOROTA
Middle Name:
Last Name:KNYSZEWSKA-DZIUDA
Suffix:
Gender:F
Credentials:MS, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:586 LITCHFIELD TPKE
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:CT
Mailing Address - Zip Code:06524-3170
Mailing Address - Country:US
Mailing Address - Phone:203-668-4062
Mailing Address - Fax:
Practice Address - Street 1:1079 WHALLEY AVE
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06515-1703
Practice Address - Country:US
Practice Address - Phone:203-668-4062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist