Provider Demographics
NPI:1841693413
Name:HABECK, AMY SUE (MS, RDN)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:SUE
Last Name:HABECK
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:SUE
Other - Last Name:DALLAPIAZZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD
Mailing Address - Street 1:50 DANBURY RD
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-4448
Mailing Address - Country:US
Mailing Address - Phone:203-838-4000
Mailing Address - Fax:
Practice Address - Street 1:50 DANBURY RD
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-4448
Practice Address - Country:US
Practice Address - Phone:203-838-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-26
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133VN1006X
CT2321133V00000X
NY008592133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic