Provider Demographics
NPI:1770792541
Name:GHIRON, LINDA (RD)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:GHIRON
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 1:255 HIGHLAND AVE # 2
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-3023
Mailing Address - Country:US
Mailing Address - Phone:781-449-1884
Mailing Address - Fax:
Practice Address - Street 1:255 HIGHLAND AVE # 2
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-3023
Practice Address - Country:US
Practice Address - Phone:781-449-1884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA489133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0022291OtherMEDICARE PTAN