Healthcare Provider Details

I. General information

NPI: 1790833986
Provider Name (Legal Business Name): MELINDA VATURRO RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2007
Last Update Date: 10/20/2022
Certification Date: 10/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 WOODLAND RD SUITE 100
STONEHAM MA
02180
US

IV. Provider business mailing address

PO BOX 1163
STRATHAM NH
03885
US

V. Phone/Fax

Practice location:
  • Phone: 781-662-6400
  • Fax:
Mailing address:
  • Phone: 603-580-9445
  • Fax: 844-252-2008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1347
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1342
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: