Provider Demographics
NPI:1881135978
Name:WEISSMAN, PAULINE FERREIRA (MS, CNS, LDN)
Entity type:Individual
Prefix:MS
First Name:PAULINE
Middle Name:FERREIRA
Last Name:WEISSMAN
Suffix:
Gender:F
Credentials:MS, CNS, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:192 PARK ROAD
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06119
Mailing Address - Country:US
Mailing Address - Phone:860-284-4406
Mailing Address - Fax:860-606-9828
Practice Address - Street 1:192 PARK ROAD
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06119
Practice Address - Country:US
Practice Address - Phone:860-284-4406
Practice Address - Fax:860-606-9828
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-09
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT50.001501133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT59.001501OtherSTATE OF CT