Elizabeth Austin Avery, MS RD CSO LDN CNSC

Individual provider Active NPI Registered Dietitian · Milton, MA

NPI 1659668366 · NPPES record last updated Aug 22, 2013

Key facts

NPI
1659668366
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
3015 (MA)
Practice address
364 Granite Ave
Milton, MA 02186-5025
Phone
(617) 698-0260
NPI assigned
Jul 1, 2011
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3015MAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
PJM Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 3015 MA Yes

Addresses

Primary practice location

364 Granite Ave
Milton, MA 02186-5025

Mailing address

191 Saint Botolph St
Apt. 4
Boston, MA 02115-5169
Phone (617) 721-7865

Other providers in Milton, MA

All providers in Milton, MA · Registered Dietitian in Massachusetts

Sources for this page

Verify at the official NPI Registry.