MEDICARE: ELIZABETH NATALE RD, LDN

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
1	133VN1006X	Metabolic Nutrition Registered Dietitian	3567	MA
2	133V00000X	Registered Dietitian	3567	MA

General Provider Information

NPI Number	:	1477982627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH NATALE RD, LDN

Provider Business Mailing Address
First Line	:	157 DALTON RD
Second Line	:
City	:	CHELMSFORD
State	:	MA
Zip	:	01824-2144
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	14 FLETCHER ST
Second Line	:
City	:	CHELMSFORD
State	:	MA
Zip	:	01824-2713
Country	:	US
Telephone Number	:	339-221-2514
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2013
Last Update Date	:	04/01/2020

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