Provider Demographics
NPI:1336326297
Name:JOY, PATRICIA ULLMANN (LDN)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ULLMANN
Last Name:JOY
Suffix:
Gender:F
Credentials:LDN
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:ANNE
Other - Last Name:ULLMANN-JOY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LDN
Mailing Address - Street 1:105 JOSEPH RD
Mailing Address - Street 2:
Mailing Address - City:BOXBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01719-1145
Mailing Address - Country:US
Mailing Address - Phone:978-264-3296
Mailing Address - Fax:978-264-3296
Practice Address - Street 1:101 COOLIDGE ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:MA
Practice Address - Zip Code:01749-1354
Practice Address - Country:US
Practice Address - Phone:978-562-3536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MANU1466133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered