Healthcare Provider Details

I. General information

NPI: 1306969530
Provider Name (Legal Business Name): MARCIA S. DOYLE MS,RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 WASHINGTON ST #783 FRANCES STERN NUTRITION CENTER,TUFTS-NEMC
BOSTON MA
02111-1526
US

IV. Provider business mailing address

80 POND ST
WESTWOOD MA
02090-3527
US

V. Phone/Fax

Practice location:
  • Phone: 617-636-5273
  • Fax: 617-636-8325
Mailing address:
  • Phone: 781-326-6077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number122
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: