Provider Demographics
NPI:1841042850
Name:MAUCHI, MALGORZATA ANNA (RDT)
Entity type:Individual
Prefix:
First Name:MALGORZATA
Middle Name:ANNA
Last Name:MAUCHI
Suffix:
Gender:F
Credentials:RDT
Other - Prefix:
Other - First Name:GOSHA
Other - Middle Name:
Other - Last Name:MAUCHI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:114 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-6233
Mailing Address - Country:US
Mailing Address - Phone:914-575-1225
Mailing Address - Fax:
Practice Address - Street 1:114 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-6233
Practice Address - Country:US
Practice Address - Phone:914-575-1225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes136A00000XDietary & Nutritional Service ProvidersDietetic Technician, Registered