Provider Demographics
NPI:1154469484
Name:REID, CHRISTINE ROSE (RD, MS)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:ROSE
Last Name:REID
Suffix:
Gender:F
Credentials:RD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 CROSS ST # 1
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-4227
Mailing Address - Country:US
Mailing Address - Phone:603-276-9385
Mailing Address - Fax:
Practice Address - Street 1:150 S HUNTINGTON AVE # 120
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-4817
Practice Address - Country:US
Practice Address - Phone:617-721-0048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered