Provider Demographics
NPI:1598964769
Name:RULAND, ROBERTA M (RD,CDE)
Entity Type:Individual
Prefix:MS
First Name:ROBERTA
Middle Name:M
Last Name:RULAND
Suffix:
Gender:F
Credentials:RD,CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 CAREW ST
Mailing Address - Street 2:DIABETES AND ENDOCRINE CENTER
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104-2301
Mailing Address - Country:US
Mailing Address - Phone:413-748-7000
Mailing Address - Fax:413-748-7185
Practice Address - Street 1:299 CAREW ST
Practice Address - Street 2:DIABETES AND ENDOCRINE CENTER
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-2301
Practice Address - Country:US
Practice Address - Phone:413-748-7000
Practice Address - Fax:413-748-7185
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MANU2593133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic