Provider Demographics
NPI:1215567508
Name:SALEH, JUMANA M (MS, RD)
Entity Type:Individual
Prefix:
First Name:JUMANA
Middle Name:M
Last Name:SALEH
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 SUMMER ST APT 54
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-6635
Mailing Address - Country:US
Mailing Address - Phone:508-333-4980
Mailing Address - Fax:
Practice Address - Street 1:14 ALLEYNE ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-2016
Practice Address - Country:US
Practice Address - Phone:617-479-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-25
Last Update Date:2020-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered