Roberta Dale Laredo, RD, LDN, CDE

Individual provider Active NPI Registered Dietitian · Newton Centre, MA

NPI 1124124359 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1124124359
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
873 (MA)
Practice address
93 Union St
Suite 300
Newton Centre, MA 02459-2244
Phone
(617) 332-4233
Fax
(617) 332-8233
NPI assigned
Sep 15, 2006
Sex
Female
Sole proprietor
Yes

Medicare Care Compare profile

Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

93 Union St
Suite 300
Newton Centre, MA 02459-2244

93 Union St
Suite 305 B
Newton Centre, MA 02459-2289
Phone (617) 710-0458

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20041201000883 MA Practitioner - Registered Dietitian Or Nutrition Professional 1759347743 Practice locations: Newton Centre, MA

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 873 MA Yes

Addresses

Primary practice location

93 Union St
Suite 300
Newton Centre, MA 02459-2244

Mailing address

31 Philmore Rd
Newton, MA 02458-2719
Phone (617) 527-9889

Other providers in Newton Centre, MA

All providers in Newton Centre, MA · Registered Dietitian in Massachusetts

Sources for this page

Verify at the official NPI Registry.