Anick Pauline Desorcy, R.D.

Individual provider Active NPI Registered Dietitian · Newport, VT

NPI 1922189786 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1922189786
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
0740000150 (VT)
Practice address
189 Prouty Dr
Newport, VT 05855-9326
Phone
(802) 334-4155
Fax
(802) 334-3585
NPI assigned
Oct 18, 2006
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
HHS exclusion list flag
The National Provider Directory flags this NPI as appearing on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
0740000150VTMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 0740000150 VT Yes

Addresses

Primary practice location

189 Prouty Dr
Newport, VT 05855-9326

Mailing address

10 Pleasant Street
Stanstead, QUEBEC J0B3E2
CA
Phone (819) 876-2596

Other providers in Newport, VT

All providers in Newport, VT · Registered Dietitian in Vermont

Sources for this page

Verify at the official NPI Registry.