Provider Demographics
NPI:1063159481
Name:CHRISTINE HUNTLEY LLC
Entity type:Organization
Organization Name:CHRISTINE HUNTLEY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN, NUTRITIONIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN
Authorized Official - Phone:978-238-8175
Mailing Address - Street 1:46 BROADWAY AVENUE EXT
Mailing Address - Street 2:
Mailing Address - City:IPSWICH
Mailing Address - State:MA
Mailing Address - Zip Code:01938-2001
Mailing Address - Country:US
Mailing Address - Phone:617-417-4870
Mailing Address - Fax:
Practice Address - Street 1:225 MAIN ST STE 14
Practice Address - Street 2:
Practice Address - City:WENHAM
Practice Address - State:MA
Practice Address - Zip Code:01984-1459
Practice Address - Country:US
Practice Address - Phone:978-238-8175
Practice Address - Fax:978-238-0391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-17
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA86105998OtherCDR