1891798906 NPI number — JANET L VECCHIONE RDN, LDN, CDCES

Table of content: JANET L VECCHIONE RDN, LDN, CDCES (NPI 1891798906)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891798906 NPI number — JANET L VECCHIONE RDN, LDN, CDCES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VECCHIONE
Provider First Name:
JANET
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RDN, LDN, CDCES
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FORFIA
Provider Other First Name:
JANET
Provider Other Middle Name:
L
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RD, LD, CDE
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1891798906
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/16/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 HURON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MASHPEE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02649-4968
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-564-3703
Provider Business Mailing Address Fax Number:
508-477-7626

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2 OAK STREET
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
MASHPEE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02649
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-564-3703
Provider Business Practice Location Address Fax Number:
508-477-7626
Provider Enumeration Date:
05/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X , with the licence number:  18 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: LD0046 . This is a "BCBS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 39758 . This is a "HPHC" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 467747 . This is a "TUFTS HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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