Healthcare Provider Details

I. General information

NPI: 1700087087
Provider Name (Legal Business Name): MARIA C NAPOLEONE MS,RD,LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 PLEASANT ST
BROCKTON MA
02301-3052
US

IV. Provider business mailing address

30 GOLDFINCH LN
PLYMOUTH MA
02360-4242
US

V. Phone/Fax

Practice location:
  • Phone: 508-586-5977
  • Fax:
Mailing address:
  • Phone: 508-747-9388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1813
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: