MS. SUSAN K PHILLIP (NPI# 1225592736) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225592736 |
| Entity Type | Individual |
| Full Name | MS. SUSAN K PHILLIP |
| Credential | NDTR |
| Practice Address |
67 Glendale St Dorchester MA 02125-2404 |
| Practice Telephone | 6172334950 |
| Mailing Telephone | 6172334950 |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2019-03-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133NN1002X |
Nutritionist Specialization: Nutrition, Education |
Dietary & Nutritional Service Providers | ||
| Y | 136A00000X | Dietetic Technician, Registered | 1018812 | Dietary & Nutritional Service Providers | |
| N | 174H00000X | Health Educator | Other Service Providers |
| Street Address |
67 GLENDALE ST |
| City | DORCHESTER |
| State | MA |
| Zip Code | 02125-2404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922520840 | Aj Guerrero | Counselor | 6 Glen St. #3, Boston, MA 02125 | 2017-07-12 |
| 1982059218 | Ana Fernandez | Psychologist | University of Massachusetts, Boston, 100 William T. Morrissey Blvd, Boston, MA 02125 | 2016-04-23 |
| 1558725184 | Algecira Garcia-ortiz | Massage Therapist | 12 Judson St, Dorchester, MASSACHUSETTS 02125 | 2016-04-10 |
| 1508251414 | Sing Hong Ty | Registered Nurse | 415 Colombia Rd, Dorchester, MA 02125 | 2015-03-30 |
| 1972806750 | Joanne Pomales | Counselor | 18 Harbor Crest Court 102, Dorchester, MA 02125 | 2010-12-16 |
| 1386969335 | Kara Jillian Sheridan | Counselor | 58 Dorset St, Boston, MA 02125 | 2010-04-02 |
| 1750533956 | Wendy M. Jern | Physical Therapist | 21riley Rd #2, Hyde Park, MA 02125 | 2008-10-21 |
| 1174729743 | Payton Brandyberry | Counselor | 500 Columbia Rd, Mail Stop 415-05, Upham's Corner Health Center, Dorchester, MA 02125 | 2007-06-21 |
| 1699817247 | Dong Lan Corporation | Pharmacist | 1167 A Dorchester Ave, Dorchester, MA 02125 | 2007-02-12 |
| 1457490153 | Sarah L Merin | Social Worker | Upham's Corner Health Center, 500 Columbia Rd, Mailstop 415-05, Dorchester, MA 02125 | 2007-02-06 |
| Find all providers in zip 02125 | ||||
| Taxonomy Code | 136A00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietetic Technician, Registered |
| A person trained in food and nutrition who is an integral part of health care and foodservice management teams. A dietetic technician, registered (DTR) has successfully completed at least a two-year associate’s degree at a US regionally accredited college or university; a dietetic technician program approved by The American Dietetic Association, including 450 hours of supervised practice experience; 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 Dietetic Technician, Registered -- a food and nutrition practitioner. Chicago, IL: The American dietetic association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730572421 | Jane Griffin | Dietetic Technician, Registered | 680 Centre St, Brockton, MA 02302-3308 | 2015-03-05 |
| 1407033608 | Michelle M Perry | Dietetic Technician, Registered | 14 Holly St, Hingham, MA 02043-1712 | 2008-01-30 |
| City | DORCHESTER |
| Zip Code | 02125 |
Please comment or provide details below to improve the information on MS. SUSAN K PHILLIP.
| 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.