Provider Demographics
NPI:1851466098
Name:MAKOWSKI, SUZANNE (RD, LDN)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:MAKOWSKI
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 POND STREET
Mailing Address - Street 2:
Mailing Address - City:UXBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01569
Mailing Address - Country:US
Mailing Address - Phone:508-278-0205
Mailing Address - Fax:401-444-5462
Practice Address - Street 1:327 POND STREET
Practice Address - Street 2:
Practice Address - City:UXBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01569
Practice Address - Country:US
Practice Address - Phone:508-278-0205
Practice Address - Fax:401-444-5462
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILDN00243133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI410007Medicare Oscar/Certification