Provider Demographics
NPI:1780113019
Name:BIONDI, SERENA (RD)
Entity type:Individual
Prefix:
First Name:SERENA
Middle Name:
Last Name:BIONDI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:SERENA
Other - Middle Name:
Other - Last Name:COCHRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:66 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-5806
Mailing Address - Country:US
Mailing Address - Phone:860-381-9619
Mailing Address - Fax:
Practice Address - Street 1:66 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-5806
Practice Address - Country:US
Practice Address - Phone:860-381-9619
Practice Address - Fax:866-823-8168
Is Sole Proprietor?:No
Enumeration Date:2017-06-09
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC133V00000X
CT1525133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered