Provider Demographics
NPI:1467736033
Name:PERNICK, RACHEL DYER (RD)
Entity Type:Individual
Prefix:MISS
First Name:RACHEL
Middle Name:DYER
Last Name:PERNICK
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 1:535 MISTIC DR
Mailing Address - Street 2:
Mailing Address - City:MARSTONS MILLS
Mailing Address - State:MA
Mailing Address - Zip Code:02648-1407
Mailing Address - Country:US
Mailing Address - Phone:774-238-0983
Mailing Address - Fax:
Practice Address - Street 1:26 WAMPUM DR
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:MA
Practice Address - Zip Code:02631-1956
Practice Address - Country:US
Practice Address - Phone:508-896-9080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered