Provider Demographics
NPI:1164887824
Name:MARON DGA PC
Entity Type:Organization
Organization Name:MARON DGA PC
Other - Org Name:DANA GROUP ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MARON
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:781-449-1143
Mailing Address - Street 1:220 RESERVOIR ST
Mailing Address - Street 2:SUITE 21
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-3149
Mailing Address - Country:US
Mailing Address - Phone:781-449-1143
Mailing Address - Fax:617-801-8022
Practice Address - Street 1:220 RESERVOIR ST
Practice Address - Street 2:SUITE 21
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-3149
Practice Address - Country:US
Practice Address - Phone:781-449-1143
Practice Address - Fax:617-801-8022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-23
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, PediatricGroup - Multi-Specialty