Provider Demographics
NPI:1801127758
Name:MEGNA NUTRITION ASSOCIATES, INC
Entity type:Organization
Organization Name:MEGNA NUTRITION ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAMILLE
Authorized Official - Middle Name:E
Authorized Official - Last Name:HENDSBEE
Authorized Official - Suffix:
Authorized Official - Credentials:LDN
Authorized Official - Phone:508-315-3042
Mailing Address - Street 1:10 W CENTRAL ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-4537
Mailing Address - Country:US
Mailing Address - Phone:508-315-3042
Mailing Address - Fax:508-315-3042
Practice Address - Street 1:10 W CENTRAL ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-4537
Practice Address - Country:US
Practice Address - Phone:508-315-3042
Practice Address - Fax:508-315-3042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-15
Last Update Date:2010-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA782133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAV30982OtherNETWORK HEALTH
MA240967OtherCIGNA
MA9242124OtherAETNA
LD0163OtherBXBS
MAAA35766OtherHARVARD PILGRIM
MA449134HENOtherUNITED HEALTH
MA478092OtherTUFTS
MAHEMT0718Medicare PIN