Provider Demographics
NPI:1245403450
Name:SCHAEFFER, JULIE M (LDN)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:M
Last Name:SCHAEFFER
Suffix:
Gender:F
Credentials:LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 ORCHARD STREET
Mailing Address - Street 2:
Mailing Address - City:MERRIMAC
Mailing Address - State:MA
Mailing Address - Zip Code:01860
Mailing Address - Country:US
Mailing Address - Phone:978-346-7102
Mailing Address - Fax:
Practice Address - Street 1:250 WASHINGTON ST
Practice Address - Street 2:6TH FLOOR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02108-4603
Practice Address - Country:US
Practice Address - Phone:617-624-6140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MANU 716133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist