MEDICARE: MS. MONIQUE BETH KAHN MS, 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	2686	MA

General Provider Information

NPI Number	:	1922277110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MONIQUE BETH KAHN MS, RD, LDN

Provider Business Mailing Address
First Line	:	15 BACON PL
Second Line	:
City	:	NEWTON
State	:	MA
Zip	:	02464-1003
Country	:	US
Telephone Number	:	617-332-9319
Fax Number	:	617-332-9319

Provider Business Practice Location Address
First Line	:	225 CEDAR HILL ST
Second Line	:	SUITE 200
City	:	MARLBOROUGH
State	:	MA
Zip	:	01752-5900
Country	:	US
Telephone Number	:	508-630-2227
Fax Number	:	508-630-2101

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

Provider Enumeration Date	:	02/21/2008
Last Update Date	:	02/21/2008

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