Provider Demographics
NPI:1063046605
Name:EPSTEIN, KATHERINE (RD, LDN)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:EPSTEIN
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 CENTRAL ST APT 2
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-2761
Mailing Address - Country:US
Mailing Address - Phone:609-273-2962
Mailing Address - Fax:
Practice Address - Street 1:3 ALLIED DR STE 303
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-6148
Practice Address - Country:US
Practice Address - Phone:617-645-4819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-22
Last Update Date:2020-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4661133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered