Provider Demographics
NPI:1952531964
Name:ANITON, ANTOINETTE F (RD)
Entity Type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:F
Last Name:ANITON
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 1:580 VILLA AVE
Mailing Address - Street 2:#110
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-1973
Mailing Address - Country:US
Mailing Address - Phone:973-449-4972
Mailing Address - Fax:
Practice Address - Street 1:580 VILLA AVE
Practice Address - Street 2:#110
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-1973
Practice Address - Country:US
Practice Address - Phone:973-449-4972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-24
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY02461-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered