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General NPI Number Information
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NPI Number | 1205178118
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Entity Type | Organization
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Legal Business Name | PYRAMID NUTRITION SERVICES
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Dates
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Enumeration Date | 03/19/2013
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Last Update Date | 03/19/2013
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Provider Practice Location Address
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Address Line | 870 MAIN ST
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City | SPRINGFIELD
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State | MA
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Zip | 01103-2105
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Country | US
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Telephone | 413-427-6340
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Fax | 413-480-0517
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Provider Business Mailing Address
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Address Line | 870 MAIN ST
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City | SPRINGFIELD
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State | MA
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Zip | 01103-2105
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Country | US
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Telephone | 413-427-6340
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Fax | 413-480-0517
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Authorized Official
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Title or Position | OWNER
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Name | MRS. NICOLE KATHLEEN FRANK-MASLAR
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Credential | RD, LDN
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Telephone | 413-427-6340
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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 | 1705
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License Number State | MA
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