Provider Demographics
NPI:1538940960
Name:DISEGNA, CHRISTINA (MS, RD, CSO, CNSC)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:DISEGNA
Suffix:
Gender:F
Credentials:MS, RD, CSO, CNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01772-1224
Mailing Address - Country:US
Mailing Address - Phone:617-320-1207
Mailing Address - Fax:
Practice Address - Street 1:20 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-3042
Practice Address - Country:US
Practice Address - Phone:774-448-3746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133VN1301X
MALDN3359133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1301XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Oncology