MEDICARE: GIUSEPPINA CEFALO BOATWRIGHT MS, RD, CHES, RYT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	4082	MA
2	133VN1201X	Obesity and Weight Management Nutrition Registered Dietitian	4082	MA

General Provider Information

NPI Number	:	1346678604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GIUSEPPINA CEFALO BOATWRIGHT MS, RD, CHES, RYT

Provider Business Mailing Address
First Line	:	1313 LAUREL ST
Second Line	:	SUITE 216
City	:	SAN CARLOS
State	:	CA
Zip	:	94070-5044
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	85 MIDDLESEX TPKE STE 3110
Second Line	:
City	:	BURLINGTON
State	:	MA
Zip	:	01803-5380
Country	:	US
Telephone Number	:	781-744-1066
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2013
Last Update Date	:	11/16/2021

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