Provider Demographics
NPI:1336272145
Name:CAPPELLO, MARION JUDITH (RD)
Entity Type:Individual
Prefix:MS
First Name:MARION
Middle Name:JUDITH
Last Name:CAPPELLO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ABENAKI RD
Mailing Address - Street 2:
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532-2433
Mailing Address - Country:US
Mailing Address - Phone:508-393-1741
Mailing Address - Fax:
Practice Address - Street 1:20 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:MA
Practice Address - Zip Code:01749-2410
Practice Address - Country:US
Practice Address - Phone:978-562-5720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2366133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered