Healthcare Provider Details

I. General information

NPI: 1083704357
Provider Name (Legal Business Name): SHARON C WESTON MS, RD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 LONGWOOD AVE
BOSTON MA
02115-5724
US

IV. Provider business mailing address

39 FATHERLAND DR
BYFIELD MA
01922-1400
US

V. Phone/Fax

Practice location:
  • Phone: 978-538-3600
  • Fax:
Mailing address:
  • Phone: 978-465-7934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number1171
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: