Mrs Susan Moffatt Agnes, RD is a
Dietitian, Registered based in East Granby, Connecticut. Mrs Susan Moffatt Agnes is licensed to practice in Connecticut (license number 709473) and her current practice location is
29 Kripes Rd, East Granby, Connecticut. She can be reached at her office (for appointments etc.) via phone at
(860) 413-3883.
NPI number for Mrs Susan Moffatt Agnes is 1518225051 and her current mailing address is Po Box 152, Simsbury, Connecticut. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1518225051.
Healthcare Provider's Profile
| Full Name | Mrs Susan Moffatt Agnes |
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| Gender | Female |
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| Speciality | Dietitian, Registered |
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| Location | 29 Kripes Rd, East Granby, Connecticut |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1518225051
- Provider Enumeration Date: 05/02/2012
- Last Update Date: 05/02/2012
Medical Identifiers
Medical identifiers for Mrs Susan Moffatt Agnes such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1518225051 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 133V00000X | Dietitian, Registered | 709473 (Connecticut) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Susan Moffatt Agnes is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mrs Susan Moffatt Agnes, RD
Po Box 152,
Simsbury, CT 06070-0152
Ph: (860) 413-3883 | Mrs Susan Moffatt Agnes, RD
29 Kripes Rd,
East Granby, CT 06026-9669
Ph: (860) 413-3883 |
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