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NPI Code Detail

MEDICARE: MAUREEN ELIZABETH GATELY RD, LDN

MEDICARE: MAUREEN ELIZABETH GATELY 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
1133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1871834523
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAUREEN ELIZABETH GATELY RD, LDN
Provider Business Mailing Address
First Line : 1101 30TH ST NW STE 250
Second Line :
City : WASHINGTON
State : DC
Zip : 20007-3796
Country : US
Telephone Number : 202-997-6372
Fax Number :
Provider Business Practice Location Address
First Line : 6302 FAIRVIEW RD STE 100
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-2227
Country : US
Telephone Number : 202-997-6372
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2013
Last Update Date : 10/03/2023

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