Provider Demographics
NPI:1275268492
Name:HAMDI, NADER (RD)
Entity Type:Individual
Prefix:
First Name:NADER
Middle Name:
Last Name:HAMDI
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 KNOWLES ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-1840
Mailing Address - Country:US
Mailing Address - Phone:916-801-2394
Mailing Address - Fax:
Practice Address - Street 1:122 GROVE ST FL 2
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038-2180
Practice Address - Country:US
Practice Address - Phone:781-269-1623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5613-NU-NU133V00000X
RILDN01196133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered