Provider Demographics
NPI:1356981310
Name:SILVA, CAITLIN (RD)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:SILVA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:
Other - Last Name:RUTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:1606 ASHBURNHAM HILL RD
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-1712
Mailing Address - Country:US
Mailing Address - Phone:978-337-4921
Mailing Address - Fax:
Practice Address - Street 1:200 GROTON RD
Practice Address - Street 2:
Practice Address - City:AYER
Practice Address - State:MA
Practice Address - Zip Code:01432-1168
Practice Address - Country:US
Practice Address - Phone:978-784-9313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-08
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86062490133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3887OtherCOMMONWEALTH OF MASSACHUSETTS DIVISION OF PROFESSIONAL LICENSURE
86062490OtherCOMMISSION ON DIETETIC REGISTRATION