Provider Demographics
NPI:1144781477
Name:NUTRIMEDY
Entity Type:Organization
Organization Name:NUTRIMEDY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NUTRITION SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:MALLORY
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, RDN, LD
Authorized Official - Phone:857-273-1335
Mailing Address - Street 1:258 HARVARD ST # 321
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-2904
Mailing Address - Country:US
Mailing Address - Phone:857-273-1335
Mailing Address - Fax:
Practice Address - Street 1:6 OCEANSIDE DRIVE
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915
Practice Address - Country:US
Practice Address - Phone:857-273-1335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-28
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty