Pamela Lynn Doubleday, RD

Individual provider Active NPI Registered Dietitian · Wolcott, CT

NPI 1003190422 · NPPES record last updated Oct 4, 2011

Key facts

NPI
1003190422
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
03297772 (CT)
Practice address
2 Hemingway Ave
Wolcott, CT 06716-2925
Phone
(203) 879-2442
Fax
(203) 879-2442
NPI assigned
Oct 4, 2011
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
03297772CTMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 03297772 CT Yes

Addresses

Primary practice location

2 Hemingway Ave
Wolcott, CT 06716-2925

Mailing address

2 Hemingway Ave
Wolcott, CT 06716-2925
Phone (203) 879-2442

Other providers in Wolcott, CT

All providers in Wolcott, CT · Registered Dietitian in Connecticut

Sources for this page

Verify at the official NPI Registry.