Provider Demographics
NPI:1770159238
Name:QUENO, ERIN E (RD)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:E
Last Name:QUENO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 JOLLEY DR STE 102
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-3061
Mailing Address - Country:US
Mailing Address - Phone:602-862-4708
Mailing Address - Fax:
Practice Address - Street 1:10 JOLLEY DR STE 102
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-3061
Practice Address - Country:US
Practice Address - Phone:860-286-2470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-03
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT86009318133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered