Provider Demographics
NPI:1477172450
Name:SAAB KHADDAJE, AFAF (MS,RD)
Entity Type:Individual
Prefix:
First Name:AFAF
Middle Name:
Last Name:SAAB KHADDAJE
Suffix:
Gender:F
Credentials:MS,RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-3247
Mailing Address - Country:US
Mailing Address - Phone:617-447-7660
Mailing Address - Fax:
Practice Address - Street 1:251 HIGH ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-3247
Practice Address - Country:US
Practice Address - Phone:617-447-7660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-10
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4955133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered