Provider Demographics
NPI:1649923210
Name:NICHOLAS MARINAKIS, MS, RDN, LDN
Entity type:Organization
Organization Name:NICHOLAS MARINAKIS, MS, RDN, LDN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NUTRITION COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MARINAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RDN, LDN
Authorized Official - Phone:978-276-4770
Mailing Address - Street 1:6 BEECHWOOD RD
Mailing Address - Street 2:
Mailing Address - City:IPSWICH
Mailing Address - State:MA
Mailing Address - Zip Code:01938-2523
Mailing Address - Country:US
Mailing Address - Phone:781-439-5148
Mailing Address - Fax:
Practice Address - Street 1:36 WOBURN ST STE 13
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-2973
Practice Address - Country:US
Practice Address - Phone:978-276-4770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty