Provider Demographics
NPI:1467534859
Name:FRATES, SUSAN E (RD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:E
Last Name:FRATES
Suffix:
Gender:F
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:PO BOX 402
Mailing Address - Street 2:
Mailing Address - City:ACCORD
Mailing Address - State:MA
Mailing Address - Zip Code:02018-0402
Mailing Address - Country:US
Mailing Address - Phone:617-460-3640
Mailing Address - Fax:
Practice Address - Street 1:8 QUEEN ANNE LN
Practice Address - Street 2:
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-3904
Practice Address - Country:US
Practice Address - Phone:617-460-3640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1851133VN1004X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric