Provider Demographics
NPI:1497090575
Name:GERATY, LAURA (MS, RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:GERATY
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1166 WASHINGTON ST # V501
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-4113
Mailing Address - Country:US
Mailing Address - Phone:781-228-1711
Mailing Address - Fax:
Practice Address - Street 1:1166 WASHINGTON ST # V501
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-4113
Practice Address - Country:US
Practice Address - Phone:781-228-1711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-30
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3406133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered