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NPI Code Detail

MEDICARE: ERIN KUTA RD

MEDICARE:   ERIN  KUTA  RD
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 Dietitian

General Provider Information

NPI Number : 1588128078
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIN KUTA RD
Provider Business Mailing Address
First Line : 1492 HIGHLAND AVE STE 4
Second Line :
City : NEEDHAM
State : MA
Zip : 02492-2606
Country : US
Telephone Number : 781-343-1478
Fax Number :
Provider Business Practice Location Address
First Line : 1492 HIGHLAND AVE STE 4
Second Line :
City : NEEDHAM
State : MA
Zip : 02492-2606
Country : US
Telephone Number : 781-343-1478
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2019
Last Update Date : 01/29/2019

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