Mireille Blacke, MA, RD, CD-N
Dietitian, Registered in Middletown, Connecticut
1861768889- Practice location
- 6122 Town Rdg, Middletown, CT 06457-6551
- Phone
- 203-233-6680
- Fax
- 860-852-3465
- Last updated
- March 23, 2012
Mireille Blacke is a Dietitian, Registered based in Middletown, CT. Mireille Blacke practices in Middletown, CT and has the professional credentials of MA, RD, CD-N. The NPI Number for Mireille Blacke is 1861768889 and holds a License No. 001082 (CT). The current practice location address for Mireille Blacke is 6122 Town Rdg, Middletown, CT 06457-6551 and can be reached out via phone at 203-233-6680 and via fax at 860-852-3465.
Provider Profile Details
- NPI Number
- 1861768889
- Provider Name
- Mireille Blacke
- Credential
- MA, RD, CD-N
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 6122 Town Rdg, Middletown, CT 06457-6551
- Phone Number
- 203-233-6680
- Fax Number
- 860-852-3465
- Primary Taxonomy
- Dietitian, Registered · 133V00000X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- March 23, 2012
- Last Update Date
- March 23, 2012
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 6122 Town Rdg
Middletown, CT 06457-6551 - City
- Middletown
- State
- Connecticut
- Zip
- 06457-6551
- Phone Number
- 203-233-6680
- Fax Number
- 860-852-3465
Provider Business Mailing Address Details
- Address
- 6122 Town Rdg
Middletown, CT 06457-6551 - City
- Middletown
- State
- CT
- Zip
- 06457-6551
- Phone Number
- 203-233-6680
- Fax Number
- 860-852-3465
License Information
- License Number (1)
- 001082
- License State (1)
- CT
- Taxonomy (1)
- Nutritionist, Nutrition, Education · 133NN1002X
- License Number (2)
- 1073878
- License State (2)
- CT
- Taxonomy (2)
- Dietitian, Registered · 133V00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Dietitian, Registered providers near Middletown, CT
View all Dietitian, Registered providers in Middletown →- Caitlin SmithDietitian, Registered · NPI 1750154357
- Luz HagoDietitian, Registered · NPI 1770814105
- Mary Braisted, RDN CDNDietitian, Registered · NPI 1831846203
- Mary L Burbank, RDDietitian, Registered · NPI 1922647601
- Mary S Izzo, RDDietitian, Registered · NPI 1760790968
- Ms. Elizabeth J Archambault, REGISTERED DIETITIANDietitian, Registered · NPI 1437375920
Frequently Asked Questions
What is the NPI number of Mireille Blacke, MA, RD, CD-N?
The NPI number of Mireille Blacke, MA, RD, CD-N is 1861768889. It was assigned on March 23, 2012 and is currently active in the NPPES registry.
What is the specialty of Mireille Blacke, MA, RD, CD-N?
Mireille Blacke, MA, RD, CD-N is registered under the primary taxonomy Dietitian, Registered (code 133V00000X), licensed in CT under license number 001082.
Where does Mireille Blacke, MA, RD, CD-N practice?
The practice location is 6122 Town Rdg, Middletown, CT 06457-6551. The office can be reached at 203-233-6680 (phone) or 860-852-3465 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1861768889 directly on the NPPES registry website.