Umass Memorial Medical Center, INC

NPI #1679131361 in Worcester, Massachusetts

Provider Information

NPI Number: 1679131361
Entity Type: Organization
Organization Name: Umass Memorial Medical Center, INC
Primary Specialty: Dietitian, Registered
Enumeration Date: May 29, 2019
Last Updated: May 29, 2019

Practice Location

Address: 55 LAKE AVE N
City: Worcester
State: Massachusetts
ZIP Code: 01655-0002
Phone: (508) 334-1000

Authorized Official

Name: MARILYN AMAYA
Title: PROVIDER ENROLLMENT SPECIALIST
Phone: (508) 334-6503

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dietitian, Registered - Nutrition, Pediatric — Nutrition, Pediatric	133VN1004X
Dietitian, Registered - Nutrition, Renal — Nutrition, Renal	133VN1005X
Dietitian, Registered - Nutrition, Metabolic — Nutrition, Metabolic	133VN1006X
Dietitian, Registered	133V00000X	Primary

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