MEDICARE: DIANE PIERZCHALA RD, LDN

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	4559	MA

General Provider Information

NPI Number	:	1750926036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANE PIERZCHALA RD, LDN

Provider Business Mailing Address
First Line	:	4 COLFAX ST
Second Line	:
City	:	PEABODY
State	:	MA
Zip	:	01960-5812
Country	:	US
Telephone Number	:	978-979-6631
Fax Number	:

Provider Business Practice Location Address
First Line	:	9 LOON HILL RD
Second Line	:
City	:	DRACUT
State	:	MA
Zip	:	01826-4365
Country	:	US
Telephone Number	:	978-323-0360
Fax Number	:

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

Provider Enumeration Date	:	11/11/2019
Last Update Date	:	11/11/2019

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