Provider Demographics
NPI:1902132707
Name:CIATTO, SUE ANN (RD)
Entity type:Individual
Prefix:MRS
First Name:SUE ANN
Middle Name:
Last Name:CIATTO
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 1:540 FEDERAL RD UNIT 2
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-2088
Mailing Address - Country:US
Mailing Address - Phone:203-740-9200
Mailing Address - Fax:
Practice Address - Street 1:540 FEDERAL RD UNIT 2
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-2088
Practice Address - Country:US
Practice Address - Phone:203-740-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-29
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY877421133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered