Provider Demographics
NPI:1003575697
Name:DHARWADKAR, ANITA NALINI (RD)
Entity Type:Individual
Prefix:MISS
First Name:ANITA
Middle Name:NALINI
Last Name:DHARWADKAR
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 ABBEY RD APT 3
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-1203
Mailing Address - Country:US
Mailing Address - Phone:248-390-0324
Mailing Address - Fax:
Practice Address - Street 1:22 ABBEY RD APT 3
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-1203
Practice Address - Country:US
Practice Address - Phone:248-390-0324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-11
Last Update Date:2021-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered