Healthcare Provider Details

I. General information

NPI: 1942270368
Provider Name (Legal Business Name): JANINE CLIFFORD-MURPHY RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 01/08/2021
Certification Date: 01/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

291 INDEPENDENCE DR
CHESTNUT HILL MA
02467-3628
US

IV. Provider business mailing address

291 INDEPENDENCE DR
CHESTNUT HILL MA
02467-3628
US

V. Phone/Fax

Practice location:
  • Phone: 617-629-6444
  • Fax: 617-629-6070
Mailing address:
  • Phone: 617-629-6444
  • Fax: 617-629-6070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1757
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: