Doctor Name: | SIVA PANCHAMOORTHY |
NPI Number: | 1558493874 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.D. |
License Number: | 1469 |
Business Practice Address: | 59 Townsend St Roxbury, MA - 021191318 |
Business Phone Number: | 6179898228 |
Business Fax Number: | |
Mailing Address: | 138 Worster Dr, MARLBOROUGH |
State: | MA |
Postal Code: | 017525004 |
Phone Number: | 5082511671 |
Fax Number: | |
NPI Enumeration Date: | 03/12/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 1469 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |