| Doctor Name: | MISS STACY AMARAL MEDEIROS |
| NPI Number: | 1912162678 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RD,LDN |
| License Number: | 000002744 |
| Business Practice Address: | 100 Rosebrook Way 3rd Floor Wareham, MA - 025711007 |
| Business Phone Number: | 5082734900 |
| Business Fax Number: | 5082734901 |
| Mailing Address: | 200 Mill Road Suite 180, FAIRHAVEN |
| State: | MA |
| Postal Code: | 027195252 |
| Phone Number: | 5089732000 |
| Fax Number: | 5089732001 |
| NPI Enumeration Date: | 07/22/2008 |
| NPI Last Update Date: | 05/07/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | 000002744 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| 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 |