Provider Demographics
NPI:1174669709
Name:ADLER, CORINNE LIVINGSTON (RD LND)
Entity Type:Individual
Prefix:MRS
First Name:CORINNE
Middle Name:LIVINGSTON
Last Name:ADLER
Suffix:
Gender:F
Credentials:RD LND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 BEACON STREET
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116
Mailing Address - Country:US
Mailing Address - Phone:617-236-1035
Mailing Address - Fax:617-247-2857
Practice Address - Street 1:278 CLARENDON
Practice Address - Street 2:SUITE 2
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116
Practice Address - Country:US
Practice Address - Phone:617-262-7111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILR116500133N00000X, 133V00000X
MA832755133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered133N00000XDietary & Nutritional Service ProvidersNutritionist
Not Answered133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA39482OtherHARVARD HEALTH CARE
MA706695OtherTUFTS HEALTH PLAN
MA706695OtherTUFTS HEALTH PLAN