Provider Demographics
NPI:1235217548
Name:HEALEY, MARGOT (RD CDE)
Entity Type:Individual
Prefix:
First Name:MARGOT
Middle Name:
Last Name:HEALEY
Suffix:
Gender:F
Credentials:RD CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CARBONE LN
Mailing Address - Street 2:
Mailing Address - City:COHASSET
Mailing Address - State:MA
Mailing Address - Zip Code:02025-1547
Mailing Address - Country:US
Mailing Address - Phone:781-366-3638
Mailing Address - Fax:833-606-1309
Practice Address - Street 1:150 RECREATION PARK DR STE 1
Practice Address - Street 2:
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-4227
Practice Address - Country:US
Practice Address - Phone:781-366-3638
Practice Address - Fax:833-606-1309
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1513133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MALD0144OtherBCBS
MA794545OtherTUFTS HEALTH
MAMT0325Medicare PIN