Sandra Marie Athanas-Moccia, RD

Individual provider Active NPI Registered Dietitian · West Roxbury, MA

NPI 1285740555 · NPPES record last updated Nov 26, 2019

Key facts

NPI
1285740555
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
666 (MA)
Practice address
1400 VFW Pkwy
West Roxbury, MA 02132-4927
Phone
(857) 203-5910
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 666 MA Yes

Addresses

Primary practice location

1400 VFW Pkwy
West Roxbury, MA 02132-4927

Mailing address

43 Hastings Rd
Dedham, MA 02026-5407
Phone (781) 320-3636

Other providers in West Roxbury, MA

All providers in West Roxbury, MA · Registered Dietitian in Massachusetts

Sources for this page

Verify at the official NPI Registry.