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General NPI Number Information
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NPI Number | 1013862721
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Entity Type | Individual
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Provider Name | MALLORY MUSCHETT
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Gender | Female
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Dates
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Enumeration Date | 02/27/2026
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Last Update Date | 02/27/2026
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Provider Practice Location Address
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Address Line | 632 BLUE HILL AVE
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City | DORCHESTER
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State | MA
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Zip | 02121-3293
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Country | US
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Telephone | 617-822-5544
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Fax |
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Provider Business Mailing Address
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Address Line | 216 ELM ST APT 2
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City | CAMBRIDGE
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State | MA
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Zip | 02139-1428
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Country | US
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Telephone | 860-918-6201
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | LDN8766
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License Number State | MA
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