Provider Demographics
NPI:1255481339
Name:ORLANDO, NANCY (MA, RD, LDN)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:ORLANDO
Suffix:
Gender:F
Credentials:MA, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 AUTUMN LN
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:MA
Mailing Address - Zip Code:01741-1732
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:56 WINTHROP ST
Practice Address - Street 2:SUITE B
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-2076
Practice Address - Country:US
Practice Address - Phone:978-287-4788
Practice Address - Fax:978-287-5126
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA158133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
Provider Identifiers
StateIdentifier IDID TypeIssuer
MALD0023OtherBLUE CROSS BLUE SHIELD
MAOR MT0512Medicare ID - Type Unspecified