Provider Demographics
NPI:1982358891
Name:PIGNONE, WANDA YVETTE (MS, RD, LDN)
Entity Type:Individual
Prefix:
First Name:WANDA
Middle Name:YVETTE
Last Name:PIGNONE
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:WANDA
Other - Middle Name:YVETTE
Other - Last Name:RIVERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, LDN
Mailing Address - Street 1:201 LELAND FARM RD
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01721-2383
Mailing Address - Country:US
Mailing Address - Phone:617-999-7150
Mailing Address - Fax:
Practice Address - Street 1:201 LELAND FARM RD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:MA
Practice Address - Zip Code:01721-2383
Practice Address - Country:US
Practice Address - Phone:617-999-7150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-09
Last Update Date:2023-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5245133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA5245OtherLDN LICENSE NUMBER