MOUNT AUBURN ATHLETIC CLUB, INC. (NPI# 1083029094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083029094 |
| Entity Type | Organization |
| Organization Name | MOUNT AUBURN ATHLETIC CLUB, INC. |
| Practice Address |
57 Coolidge Ave Watertown MA 02472-2802 |
| Practice Telephone | 6179230055 |
| Practice Fax Number | 6178128016 |
| Mailing Telephone | 6179230055 |
| Mailing Fax Number | 6178128016 |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2015-03-09 |
| Authorized Official Name | PAUL CROWLEY (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6179230055 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers |
| Street Address |
57 COOLIDGE AVE |
| City | WATERTOWN |
| State | MA |
| Zip Code | 02472-2802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245639285 | Julie A Jacobsen | Dietitian, Registered | 57 Coolidge Ave, Watertown, MA 02472 | 2014-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548735327 | Gladys Nakungu Kasansula | Counselor | Square Medical Group, 124 Watertown Street, Suite 2d, Watertown, MA 02472 | 2018-10-09 |
| 1447741962 | Hannah Edward | Optometrist | 550 Arsenal Street, Watertown, MA 02472 | 2018-05-21 |
| 1982193504 | Ruth Audrey Silverstein | Social Worker | Perkins School for The Blind, 175 North Beacon Street, Watertown, MA 02472 | 2018-05-09 |
| 1376067355 | Mostafa Medhati | Acupuncturist | 265 Lexington St., Watertown, MA 02472 | 2017-08-01 |
| 1003346313 | Eric Trant | Specialist/Technologist | 50 Columbia Street, Watertown, MA 02472 | 2017-06-19 |
| 1477007730 | Neangkanika Chea | Nurse Practitioner | 2 Repton Place, Apt 2204, Watertown, MA 02472 | 2016-08-04 |
| 1396128120 | Michelle Soares Darocha | Dentist | 18 Hovey Street, Watertown, MA 02472 | 2015-06-29 |
| 1760875496 | Ece Evin Yildirim | Acupuncturist | 557 Mt. Auburn St, Watertown, MA 02472 | 2015-03-05 |
| 1396140927 | Fabrizia Torazzi | Behavioral Analyst | 51 Water Street, Suite 200, Watertown, MA 02472 | 2014-10-24 |
| 1265774392 | Emilia Ann Fulop | Social Worker | 127 North Beacon Street, Watertown, MA 02472 | 2013-03-27 |
| Find all providers in zip 02472 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003448085 | Mariana Olga Serback | Dietitian, Registered | 19500 Woodside Dr, Watertown, NY 13601-4458 | 2020-02-07 |
| 1245878032 | Samantha Kay Kratovil | Dietitian, Registered | 4 19th St Ne, Watertown, SD 57201 | 2019-12-12 |
| 1265097984 | Sarah Zappone | Dietitian, Registered | 350 Claxton Ave, Watertown, CT 06795-1947 | 2019-05-08 |
| 1619452059 | Rachel M Caine | Dietitian, Registered | 83 Palfrey St, Watertown, MA 02472-4705 | 2018-10-02 |
| 1861990400 | Hannah Meier | Dietitian, Registered | 40 Fuller Rd, Watertown, MA 02472-3313 | 2018-01-29 |
| 1780112763 | Devon Haines | Dietitian, Registered | 23 Main St Fl 2, Watertown, MA 02472-4403 | 2017-06-02 |
| 1003266453 | Watertown Urban Mission | Dietitian, Registered | 247 Factory St, Watertown, NY 13601-2748 | 2016-06-16 |
| 1164812913 | Anne Godina | Dietitian, Registered | 300 Woodview Way, Unit 216, Watertown, MA 02472-4847 | 2015-02-02 |
| 1669883567 | Megan Wiesner | Dietitian, Registered | 3336 17th Ave Sw, Watertown, SD 57201-6005 | 2014-05-13 |
| 1609129527 | Sheryl Sterling-skinner | Dietitian, Registered | 25682 Military Rd, Watertown, NY 13601-5222 | 2012-10-16 |
| Find all providers in WATERTOWN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.