Provider Demographics
NPI:1679797708
Name:RUSSELL-CURTIS, SUZANNE LEE (RD, LDN, CDE)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:LEE
Last Name:RUSSELL-CURTIS
Suffix:
Gender:F
Credentials:RD, LDN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 OLD COLONY LN
Mailing Address - Street 2:UNIT 218
Mailing Address - City:MARSHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02050-3639
Mailing Address - Country:US
Mailing Address - Phone:617-653-4845
Mailing Address - Fax:
Practice Address - Street 1:15 PARKMAN ST
Practice Address - Street 2:WANG AMBULATORY CARE CENTER, 5TH FLOOR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3117
Practice Address - Country:US
Practice Address - Phone:617-724-6350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA1400133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education