NPI 1285740555 · live from the CMS NPI Registry
Sandra Marie Athanas-Moccia, RD
Dietitian, Registered in West Roxbury, MA. National Provider Identifier 1285740555, active.
NPI record
| NPI | 1285740555 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 1400 Vfw Pkwy, West Roxbury, MA 02132 |
| Practice phone | 857-203-5910 |
| Mailing address | 43 Hastings Rd, Dedham, MA 02026 |
| Enumerated | August 21, 2006 |
| Last updated | November 26, 2019 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 666 (MA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.