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NPI Code Detail

MEDICARE: MRS. MARY-JENNIFER HANLON R.D., L.D.N

MEDICARE: MRS. MARY-JENNIFER HANLON R.D., L.D.N
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian1232MA

General Provider Information

NPI Number : 1225046642
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY-JENNIFER HANLON R.D., L.D.N
Provider Business Mailing Address
First Line : 39 W POND RD
Second Line :
City : PLYMOUTH
State : MA
Zip : 02360-4732
Country : US
Telephone Number : 508-747-6085
Fax Number :
Provider Business Practice Location Address
First Line : 16 ALDRIN RD
Second Line : PLYMOUTH NUTRITION
City : PLYMOUTH
State : MA
Zip : 02360-4804
Country : US
Telephone Number : 508-746-7448
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2006
Last Update Date : 07/08/2007

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