Healthcare Provider Details

I. General information

NPI: 1972447373
Provider Name (Legal Business Name): CATHERINE NASHAAT GHATTAS-PUYLARA RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CATHERNINE NASHAAT GHATTAS RD

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 PINE CREST DR
WORCESTER MA
01604-1415
US

IV. Provider business mailing address

33 PINE CREST DR
WORCESTER MA
01604-1415
US

V. Phone/Fax

Practice location:
  • Phone: 857-208-8698
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLDN8777
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: