Provider Demographics
NPI:1164240016
Name:D'AMELIO, JULIA (RDN, LDN)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:D'AMELIO
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06795-2440
Mailing Address - Country:US
Mailing Address - Phone:203-592-6214
Mailing Address - Fax:
Practice Address - Street 1:156 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:CT
Practice Address - Zip Code:06795-2440
Practice Address - Country:US
Practice Address - Phone:203-592-6214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT59.002708133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered