Provider Demographics
NPI:1073836565
Name:MACNEIL, INMAY P (MS, RD, LDN)
Entity Type:Individual
Prefix:
First Name:INMAY
Middle Name:P
Last Name:MACNEIL
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:INMAY
Other - Middle Name:P
Other - Last Name:KIELY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:5 NEPONSET ST FL 12
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-2714
Mailing Address - Country:US
Mailing Address - Phone:508-852-6175
Mailing Address - Fax:508-595-2123
Practice Address - Street 1:5 NEPONSET ST FL 12
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01606-2714
Practice Address - Country:US
Practice Address - Phone:508-852-6175
Practice Address - Fax:508-595-2123
Is Sole Proprietor?:No
Enumeration Date:2010-03-11
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2980133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered