=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891798906
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JANET L VECCHIONE RDN, LDN, CDCES
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/23/2005
-----------------------------------------------------
Last Update Date | 02/16/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2 OAK STREET SUITE 201
-----------------------------------------------------
City | MASHPEE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02649
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-564-3703
-----------------------------------------------------
Fax | 508-477-7626
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10 HURON AVE
-----------------------------------------------------
City | MASHPEE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02649-4968
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-564-3703
-----------------------------------------------------
Fax | 508-477-7626
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number | 18
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------