Provider Demographics
NPI:1194175372
Name:NEWMAN, JENNIFER (MS, RD, LDN, CDCES)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:MS, RD, LDN, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:STABILITY HEALTH
Mailing Address - Street 2:120 FRONT STREET, SUITE 440
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608
Mailing Address - Country:US
Mailing Address - Phone:857-702-2171
Mailing Address - Fax:508-637-9241
Practice Address - Street 1:STABILITY HEALTH
Practice Address - Street 2:120 FRONT STREET, SUITE 440
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608
Practice Address - Country:US
Practice Address - Phone:857-702-2171
Practice Address - Fax:508-637-9241
Is Sole Proprietor?:No
Enumeration Date:2016-06-17
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3274133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered