IndividualActive
Ethan Balk, PHD, RD
NPI 1124535372 · Metabolic Nutrition Registered Dietitian · New Haven, CT
Provider details
- NPI number
- 1124535372
- Entity type
- Individual
- Primary specialty
- Metabolic Nutrition Registered DietitianDietary & Nutritional Service Providers
- Credential
- PHD, RD
- Sex
- Male
- Sole proprietor
- No
- License
- 1448 (CT)
Mailing address
40 Temple St Ste 7b
New Haven, CT 06510-2715
Registry dates
- Enumerated
- 2018-01-09
- Last updated
- 2018-01-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.