Provider Demographics
NPI:1194979138
Name:EFSTATHION, ANN VERONICA (MS, RD, LDN)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:VERONICA
Last Name:EFSTATHION
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 WASHINGTON ST.
Mailing Address - Street 2:#783 TUFT'S MEDICAL CENTER FRANCES STERN NUTRITION CENT
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111
Mailing Address - Country:US
Mailing Address - Phone:617-636-5273
Mailing Address - Fax:617-636-8325
Practice Address - Street 1:800 WASHINGTON ST.
Practice Address - Street 2:TUFT'S MEDICAL CENTER FRANCES STERN NUTRITION CENTER
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111
Practice Address - Country:US
Practice Address - Phone:617-636-5273
Practice Address - Fax:617-636-8325
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1480133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered