Thrive Nutrition of CT, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

001294 Issued in CT

Legal business name

THRIVE NUTRITION OF CT, LLC

Practice address

199 Ethan Allen Hwy
Ridgefield, CT 06877-6212

Phone

(914) 320-3197

NPI assigned

Mar 14, 2016

Organization subpart

Yes

Parent organization

199 OFFICE SPACE, LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Rena A Bruckman, MS, RD

Title

Nutritionist

Phone

(914) 320-3197

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1457913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457913600000",
    "number": "1720449184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 ETHAN ALLEN HWY",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068776212",
            "telephone_number": "914-320-3197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 ETHAN ALLEN HWY",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068776212",
            "telephone_number": "914-320-3197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THRIVE NUTRITION OF CT, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "199 OFFICE SPACE, LLC",
        "enumeration_date": "2016-03-14",
        "last_updated": "2016-03-14",
        "status": "A",
        "authorized_official_last_name": "BRUCKMAN",
        "authorized_official_first_name": "RENA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "NUTRITIONIST",
        "authorized_official_telephone_number": "914-320-3197",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS, RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": "CT",
            "license": "001294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresita G Mascardo MD PC (Connecticut Plastic Surgery Center)
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• Joanne Thompson, MD
• Yvette Tola Thompson, PSY.D.
• Thrive Psychotherapy, LLC
• Holli Erin Tierno, PHARMD
• Ma. Concepcion Tomasetti
• Tooth Fairy Pediatric Dentistry
• Alessandra Tornatore, BCBA

• Registered Dietitian in Ridgefield, CT
• Providers in Ridgefield, CT by specialty
• Registered Dietitian in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.