Provider Demographics
NPI:1205982469
Name:NAWATHE, SWATI W (RD, LDN)
Entity type:Individual
Prefix:
First Name:SWATI
Middle Name:W
Last Name:NAWATHE
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 1:26 MORRISON LN
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-1193
Mailing Address - Country:US
Mailing Address - Phone:978-760-0146
Mailing Address - Fax:978-418-0095
Practice Address - Street 1:26 MORRISON LN
Practice Address - Street 2:
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-1193
Practice Address - Country:US
Practice Address - Phone:978-760-0146
Practice Address - Fax:978-418-0095
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1838133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANA MT0768Medicare ID - Type UnspecifiedREGISTERED DIETITIAN