Provider Demographics
NPI:1659044758
Name:LAUBACH SANTARO, NATALIE J (RDN)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:J
Last Name:LAUBACH SANTARO
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:J
Other - Last Name:LAUBACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN
Mailing Address - Street 1:455 TOLL GATE RD
Mailing Address - Street 2:PRC AND CREDENTIALING
Mailing Address - City:BROCKTON
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2759
Mailing Address - Country:US
Mailing Address - Phone:401-273-0641
Mailing Address - Fax:401-273-2919
Practice Address - Street 1:111 BREWSTER ST
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-4400
Practice Address - Country:US
Practice Address - Phone:401-729-2304
Practice Address - Fax:401-729-2923
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILDN01214133V00000X, 133V00000X
133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered