Provider Demographics
NPI:1073843843
Name:STONE, ROBIN (MS, RDN, LDN)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 EMERSON AVE
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01930-2583
Mailing Address - Country:US
Mailing Address - Phone:978-283-6776
Mailing Address - Fax:978-282-9684
Practice Address - Street 1:28 EMERSON AVE
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:MA
Practice Address - Zip Code:01930-2583
Practice Address - Country:US
Practice Address - Phone:978-283-6776
Practice Address - Fax:978-282-9684
Is Sole Proprietor?:No
Enumeration Date:2009-12-30
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3167133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered