MARY LOUISE BURBANK (NPI# 1922647601) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922647601 |
| Entity Type | Individual |
| Full Name | MARY LOUISE BURBANK |
| Other Name | MARY LOUISE GATES |
| Credential | RD |
| Practice Address |
540 Saybrook Rd Ste 100 Middletown CT 06457-4760 |
| Mailing Address |
179 Russell St Middletown CT 06457-4323 |
| Practice Telephone | 8602871078 |
| Enumeration Date | 2019-12-30 |
| Last Update Date | 2019-12-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 001431 | CT | Dietary & Nutritional Service Providers |
| Street Address |
540 SAYBROOK RD STE 100 |
| City | MIDDLETOWN |
| State | CT |
| Zip Code | 06457-4760 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053787564 | Mhs Primary Care Inc. | Dermatology | 540 Saybrook Rd Ste 100, Middletown, CT 06457-4760 | 2015-08-19 |
| 1518513647 | Dana Marie Cantiello | Nurse Practitioner | 540 Saybrook Rd Ste 100, Middletown, CT 06457-4760 | 2019-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699391961 | Meghan Harrington | Behavior Technician | 101 Centerpoint Drive #243, Middletown, CT 06457 | 2020-06-22 |
| 1427619626 | Collaborative Aba Services, LLC | Behavioral Analyst | 515 Centerpoint Drive, Suite 205, Middletown, CT 06457 | 2019-06-27 |
| 1376100339 | Kimberly Tynik | Pharmacist | 451 Fowler Ave, Middletown, CT 06457 | 2019-05-24 |
| 1184101263 | Tabrez Adil | Dentist | 675 Main St., Middletown, CT 06457 | 2018-07-23 |
| 1326535337 | Rehan Khan | Non-emergency Medical Transport (VAN) | 765 Country Club Rd, Middletown, CT 06457 | 2018-04-16 |
| 1366950206 | State of Connecticut | Psychiatric Hospital | 70 O'brien Drive, Middletown, CT 06457 | 2018-01-12 |
| 1902324536 | Cynthia Tine | Physical Therapy Assistant | 628 Congdon Street, Middletown, CT 06457 | 2017-09-04 |
| 1619494390 | Nathan Douglas Roy | Specialist/Technologist | 431 Briarwood Lane, Middletown, CT 06457 | 2017-08-24 |
| 1598286502 | Rachel Hoffman Whelen | Registered Nurse | 420 Saybrook Road, Suite A, Middletown, CT 06457 | 2017-06-29 |
| 1003358326 | Rebecca Rotondo | Social Worker | 230 Main Street Extension, Act Team, Gilead Community Services, Middletown, CT 06457 | 2016-11-17 |
| Find all providers in zip 06457 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700496460 | Kelci Marie Mchugh | Dietitian, Registered | 100 Henrick Dr, Middletown, OH 45044-5433 | 2020-08-06 |
| 1902414113 | Monica Eva Marcello | Dietitian, Registered | 808 Wadsworth St, Middletown, CT 06457-4027 | 2020-07-14 |
| 1801423124 | Jaclyn Nicole Esbenshade | Dietitian, Registered | 529 Wheelmen St, Middletown, DE 19709-0027 | 2020-03-25 |
| 1679107460 | Megan Tessier | Dietitian, Registered | 85 Compton View Dr, Middletown, RI 02842-7615 | 2020-03-02 |
| 1134769359 | Cindra Ann Holland | Dietitian, Registered | 16 E Sarazen Dr, Middletown, DE 19709-7940 | 2020-01-15 |
| 1548801194 | Victoria Coglianese | Dietitian, Registered | 146 Hillyer Circle, Middletown, Nj, Usa, Middletown, NJ 07748 | 2019-10-04 |
| 1265915110 | Kamie Nicole Stoner | Dietitian, Registered | 1909 Sherman Ave, Middletown, OH 45044-4456 | 2018-09-06 |
| 1497280283 | Melanie Williams | Dietitian, Registered | 4 Banfield Ct, Middletown, NJ 07748-2542 | 2017-04-29 |
| 1346796570 | Michelle Caravella | Dietitian, Registered | 113 Lynch Rd, Middletown, NJ 07748 | 2016-08-28 |
| 1962804237 | Kelly Ann Pollock | Dietitian, Registered | 60 Peach Pl, Middletown, NY 10940-6944 | 2014-09-18 |
| Find all providers in MIDDLETOWN | ||||
| City | MIDDLETOWN |
| Zip Code | 06457 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.