MEDICARE: HOPE HAYES 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
1	133V00000X	Registered Dietitian	0774	NH

General Provider Information

NPI Number	:	1821471749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOPE HAYES RD

Provider Business Mailing Address
First Line	:	92 CHARLOTTE POINT ROAD
Second Line	:
City	:	SILVER LAKE
State	:	NH
Zip	:	03875
Country	:	US
Telephone Number	:	781-254-4230
Fax Number	:

Provider Business Practice Location Address
First Line	:	92 CHARLOTTE POINT ROAD
Second Line	:
City	:	SILVER LAKE
State	:	NH
Zip	:	03875
Country	:	US
Telephone Number	:	781-254-4230
Fax Number	:

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

Provider Enumeration Date	:	07/09/2015
Last Update Date	:	07/09/2015

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Directions to “ HOPE HAYES RD” Practice Location

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