| Organization Name: | PAT VASCONCELLOS |
| NPI Number: | 1124140215 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PAT ANNA VASCONCELLOS (REGISTERED DIETITIAN, DIABETES EDUC) |
| Mailing Address: | 133 Falmouth Rd Ste F Mashpee |
| State: | MA US |
| Postal Code: | 026492611 |
| Phone Number: | 5082461724 |
| Fax Number: | |
| NPI Enumeration Date: | 04/06/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133VN1006X |
| License Number: | 1741 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | Nutrition, Metabolic |
| Taxonomy Definition: | |