Provider Demographics
NPI:1972835858
Name:OLIVEIRA, NANCY L (MS, RD, LDN)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:L
Last Name:OLIVEIRA
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 1:1153 CENTRE ST
Mailing Address - Street 2:DANA-FARBER/BWCC AT FAULKNER HOSPITAL
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02130-3446
Mailing Address - Country:US
Mailing Address - Phone:617-983-4593
Mailing Address - Fax:617-983-7138
Practice Address - Street 1:1153 CENTRE ST
Practice Address - Street 2:DANA-FARBER/BWCC AT FAULKNER HOSPITAL, NUTRITION DEPT.
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02130-3446
Practice Address - Country:US
Practice Address - Phone:617-983-4593
Practice Address - Fax:617-983-7138
Is Sole Proprietor?:No
Enumeration Date:2010-02-03
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2926133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered