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NPI Code Detail

MEDICARE: REBEKAH A DONELAN RD

MEDICARE: REBEKAH A DONELAN RD
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
1133V00000XRegistered Dietitian541MA

General Provider Information

NPI Number : 1588737639
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBEKAH A DONELAN RD
Provider Business Mailing Address
First Line : 149 BEL AIR DR
Second Line :
City : FITCHBURG
State : MA
Zip : 01420-6157
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 233 AYER RD
Second Line : SUITE 5B
City : HARVARD
State : MA
Zip : 01451-1131
Country : US
Telephone Number : 978-273-9524
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2006
Last Update Date : 01/12/2012

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