Healthcare Provider Details

I. General information

NPI: 1235217548
Provider Name (Legal Business Name): MARGOT HEALEY RD CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 09/05/2023
Certification Date: 09/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 RECREATION PARK DR STE 1
HINGHAM MA
02043-4227
US

IV. Provider business mailing address

8 CARBONE LN
COHASSET MA
02025-1547
US

V. Phone/Fax

Practice location:
  • Phone: 781-366-3638
  • Fax: 833-606-1309
Mailing address:
  • Phone: 781-366-3638
  • Fax: 833-606-1309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1513
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: