Provider Demographics
NPI:1457776643
Name:MENEZES, SARAH JANE (RD LDN)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:JANE
Last Name:MENEZES
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 1:42 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:MA
Mailing Address - Zip Code:01749-2010
Mailing Address - Country:US
Mailing Address - Phone:857-265-6644
Mailing Address - Fax:
Practice Address - Street 1:42 RIVER ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:MA
Practice Address - Zip Code:01749-2010
Practice Address - Country:US
Practice Address - Phone:857-265-6644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-24
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3250133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered