Healthcare Provider Details

I. General information

NPI: 1982569430
Provider Name (Legal Business Name): JIAXIN LAI RDN, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALINA JIAXIN LAI RDN, LDN

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 EVERETT AVE APT 3309
CHELSEA MA
02150-1807
US

IV. Provider business mailing address

151 EVERETT AVE
CHELSEA MA
02150-1807
US

V. Phone/Fax

Practice location:
  • Phone: 617-887-3584
  • Fax: 929-270-7005
Mailing address:
  • Phone: 617-887-3584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License NumberLDN8589
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: