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General NPI Number Information
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NPI Number | 1124192505
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Entity Type | Individual
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Provider Name | JANE FRANCES POLLEY RD, LDN
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Gender | Female
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 203 OAK ST LONGFELLOW SPORTS CLUB
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City | NATICK
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State | MA
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Zip | 01760-1306
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Country | US
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Telephone | 508-653-4633
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Fax | 508-650-4986
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Provider Business Mailing Address
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Address Line | 210 NAHANTON ST BOX 106
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City | NEWTON CENTER
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State | MA
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Zip | 02459-2954
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Country | US
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Telephone | 508-641-4321
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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 | LDN1011
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License Number State | MA
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