Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jack Surgenor

Individual provider Registered Dietitian · NPI 1093677650

Jack Surgenor is a Registered Dietitian in Durham, Connecticut. Licensed in Connecticut. Registered with an NPI since 2025.

Licensed in
CT
In the registry since
2025

Practice location Address checks out

20 Laurel Trl
Durham, CT 06422-3400
Phone: (203) 464-9095
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence 3048 (CT)

Record details

NPI number1093677650
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 2, 2025
Last updated in NPPESDecember 2, 2025
Certification dateDecember 2, 2025
Mailing address20 Laurel Trl, Durham, CT 06422-3400

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