Provider Demographics
NPI:1740311190
Name:BUCHBINDER, JOAN CAROL (MS, RD, LDN, FADA)
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:CAROL
Last Name:BUCHBINDER
Suffix:
Gender:F
Credentials:MS, RD, LDN, FADA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307 GREAT PLAIN AVE
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-1751
Mailing Address - Country:US
Mailing Address - Phone:617-558-5536
Mailing Address - Fax:781-444-0076
Practice Address - Street 1:1307 GREAT PLAIN AVE
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-1751
Practice Address - Country:US
Practice Address - Phone:617-558-5536
Practice Address - Fax:781-444-0076
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA465133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA39224OtherPILGRIMHEALTHCARE
MA719686OtherTUFTSHEALTH PLAN PROVIDER