Provider Demographics
NPI:1689550774
Name:PRUTTING, ALEXANDRA A (RDN)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:A
Last Name:PRUTTING
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:378 BUCKINGHAM AVE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-6610
Mailing Address - Country:US
Mailing Address - Phone:203-993-4351
Mailing Address - Fax:
Practice Address - Street 1:378 BUCKINGHAM AVE
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-6610
Practice Address - Country:US
Practice Address - Phone:203-993-4351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered