Healthcare Provider Details

I. General information

NPI: 1821969890
Provider Name (Legal Business Name): AOIFE O'FLAHERTY RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2025
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

588 E 6TH ST
SOUTH BOSTON MA
02127-3130
US

IV. Provider business mailing address

588 E 6TH ST
SOUTH BOSTON MA
02127-3130
US

V. Phone/Fax

Practice location:
  • Phone: 857-210-6998
  • Fax:
Mailing address:
  • Phone: 857-210-6998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License NumberLDN8344
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: